Clinical Study of non-traumatic causes and management of generalized peritonitis

Abstract

Background: Peritonitis refers to an inflammatory response of the peritoneum in the abdominal cavity in terms of activation of local mediator cascades by different stimuli. Therefore, bacterial, viral and chemical agents may cause inflammation of the peritoneal layer. Secondary peritonitis is usually due to spillage of gastrointestinal or genitourinary microorganisms into the peritoneal cavity as a result of loss of integrity of the mucosal barrier. Methods: Cross sectional observational study was performed. All patients admitted and treated for perforation secondary to non-traumatic hollow viscus perforation in surgical units of Department of General Surgery, Government Medical College, Nalgonda, Telangana, India, during the period of October 2019 - September 2021. A detailed history was taken and all the patients were subjected to thorough clinical examination. Patients subjected to laparotomy are followed in post-operative period to know the complications, morbidity and mortality rates. General condition at the time of admission was monitored by noting presenting complaints, pulse, BP, respiratory rate, hydration status. Operative findings were recorded. Necessary surgical intervention done is recorded; post operatively patients will be followed up for any complications. Each case will be studied as per the proforma. Results: The most common age group was 40- 60yrs (53.3%) in the present study. Major etiological factor noted is gastric perforation and next is appendicular perforation& duodenal ulcer perforation. In this study pain abdomen was the predominant symptom and was presented in all cases (100%). In this study guarding/rigidity was seen in all cases (100%). Most of the cases had a mean duration of 10-19days of hospital stay. Mortality rate was found to be 16.6%. Conclusion: In our study, youngest age of small intestine perforation was 23years and oldest was 80 years. Most cases had a duration of hospital stay of 10- 19 days. Main presenting complaint was pain abdomen, vomiting, fever and distension of abdomen. Risk factors for perforations were smoking, tobacco, alcohol and NSAIDs.