NON APPENDICULAR PERFORATION PERITONITIS

Abstract

Objectives: To evaluate the spectrum of non-appendicular perforation peritonitisand their management outcome in a peripheral teaching hospitals. Study design: Retrospectivedescriptive, Interventional. Setting: Surgical Department Aziz Bhatti Shaheed (Teaching)Hospital Nawaz Sharif Medical College University of Gujrat& Surgical Department Islam MedicalCollege Sialkot. Study period: February 2011 to June 2013. Results: All the patients with clinicaldiagnosis of Acute Peritonitis were included, however patients with peritonitis secondary toperforated appendix and traumatic GIT perforations were excluded from study when foundpreoperatively. Total 100 patients with acute peritonitis were operated. 79 patients were male and21 were female. Mean age was 39.9 years, youngest patient was a 12 year old boy whereas oldestwas 73 year old. Perforated duodenal ulcer was the commonest cause of peritonitis seen in 42cases followed by intestinal tuberculosis 18%. Enteric gut perforation was seen in 17% cases.Mortality was 9% and sepsis and multi organ failure was the main cause of death. Conclusions:Management of perforation peritonitis is a complex and demanding. We can avoid thiscomplication by primary prevention, adequate& timely treatment of diseases like Peptic ulcer,tuberculosis and Typhoid fever which are the commonest cause of GUT perforations in Easternregion/ Tropical countries. Early diagnosis of acute peritonitis, adequate efficient resuscitationand early exploration preferable within six hours is the key to reduce both morbidity and mortalitythese patients