Spectrum of Perforation peritonitis in Bhopal with special reference to NSAID induced GI perforations

Abstract

Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world. The aim of this study is to provide an overview of the spectrum of perforation peritonitis managed in People’s hospital of PCMS &RC, Bhopal along with NSAD induced GI perforations. Method: This retrospective study conducted at People’s hospital of People’s college of medical sciences & Research centre, Bhopal between July 2010 and January 29, 2015 .It included 300 patients of perforation peritonitis who underwent exploratory laparotomy were studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, outcome, history of addiction, income group, co morbid condition, history of NSAID intake. Results: The commonest cause of perforation peritonitis was peptic ulcer disease 110 cases (75 duodenal ulcers and 35 gastric ulcers) followed by appendicitis (82 cases), typhoid fever (48 cases), tuberculosis (42 cases), and trauma (15). The overall mortality was 4.33 %. Conclusions: Perforation peritonitis in India has a different spectrum as compared to western countries. The most common cause of perforation peritonitis was peptic ulcer disease followed by perforated appendicular perforations and small bowel typhoid perforation. Aggressive resuscitation with correction of electrolyte imbalance followed by early surgical intervention under the cover of broad spectrum antibiotics is the key for good outcome. NSAID induced GI perforations can be prevented by patient education and following the dictum of prescribing the correct drug in the minimum effective dose.