IJCRR - Vol 07 Issue 15, August, 2015
ANALYSIS OF FACTORS ASSOCIATED WITH PERITONITIS IN HOLLOW VISCUS PERFORATION
Author: Atif Abdullah C., Ganesh Babu C.P., Raghuram K., Tirou Aroul T.
Background: Peritonitis due to hollow viscus perforation is one of the causes of acute abdomen warranting emergency laparotomy.
The causes for gastro-intestinal perforation vary between the western countries and Asian countries like India. Though
there are many studies in this regard, very limited studies are available pertaining to southern parts of India. Therefore this study
was carried out to assess the common cause, factors associated and patient outcome in peritonitis due to gastro-intestinal perforation.
Methods: This study was conducted in tertiary care hospital, Pondicherry between July 2012 and July 2014. Fifty five patients who underwent exploratory laparotomy for gastro-intestinal perforation were included in the study and assessed. Appropriate surgeries were performed for the site and cause of the perforation. Patient’s history, clinical examination findings, investigations, intra-operative findings, operative procedure and post-operative complications were recorded and assessed.
Results: In this study, 21.8% patients were in the age group of 51-60 years. Male to female ratio was found to be 6.8:1. The most common symptom was abdominal pain which was present in all the patients. Among patients with peptic ulcer perforation, 73.3% of the patients were smokers and 42.4% of the patients gave history of NSAID intake. Peptic ulcer perforation was found in 60% of the patients. Post-operative complications occurred in 34.5% of the patients. Mortality rate was 7.3% in this study.
Conclusion: Even in the Era of good drugs Peptic ulcer perforation was the commonest cause for perforation. Peptic ulcer perforation was significantly associated with smoking in this study. Alcohol consumption, prior NSAID abuse didn’t significantly affect the outcome of the patients.
Keywords: Perforation, Factors associated, Peritonitis
Atif Abdullah C., Ganesh Babu C.P., Raghuram K., Tirou Aroul T.. ANALYSIS OF FACTORS ASSOCIATED WITH PERITONITIS IN HOLLOW VISCUS PERFORATION International Journal of Current Research and Review. Vol 07 Issue 15, August, 56-61
1. Yadav D, Garg PK. Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience. Indian J Surg. 2013 Apr;75(2):133–7.
2. Chakma SM, Singh RL, Parmekar MV, Singh KG, Kapa B, Sharatchandra KH, et al. Spectrum of Perforation Peritonitis. J Clin Diagn Res JCDR. 2013;7(11):2518.
3. Jhobta RS, Attri AK, Kaushik R, Sharma R, Jhobta A. World Journal of Emergency Surgery. World J Emerg Surg. 2006;1:26.
4. Afridi SP, Malik F, Ur-Rahman S, Shamim S, Samo KA. World Journal of Emergency Surgery. World J Emerg Surg. 2008;3:31.
5. Bali RS, Verma S, Agarwal PN, Singh R, Talwar N. Perforation Peritonitis and the Developing World. IntSch Res Not [Internet]. 2014 [cited 2014 Aug 13];2014. Available from: http://www. hindawi.com/journals/isrn/2014/105492/abs/
6. Chatterjee H, Pai D, Jagdish S, Satish N, Jayadev D, Srikanthreddy P. Pattern of nontyphoidileal perforation over three dec- ades in Pondicherry. Trop Gastroenterol Off J Dig Dis Found. 2003 Sep;24(3):144–7.
7. Nuhu A, Kassama Y. Experience with acute perforated duodenal ulcer in a West African population. Niger J Med J Natl Assoc Resid Dr Niger. 2008 Dec;17(4):403–6.
8. Ohene-Yeboah M, Togbe B. Perforated gastric and duodenal ulcers in an urban African population. West Afr J Med. 2006 Sep;25(3):205–11.
9. Malangoni MA, Inui T. Peritonitis - the Western experience. World J Emerg Surg WJES. 2006;1.
10. Dakubo JCB, Naaeder SB, Clegg-Lamptey JN.Gastro-duodenal peptic ulcer perforation. East Afr Med J. 2009 Mar;86(3):100–9.
11. Leeman MF, Skouras C, Paterson-Brown S. The management of perforated gastric ulcers. Int J SurgLond Engl. 2013;11(4):322– 4.
12. Chaudhary A, Bose SM, Gupta NM, Wig JD, Khanna SK. Giant perforations of duodenal ulcer. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 1991 Jan;10(1):14–5.
13. Noguiera C, Silva AS, Santos JN, Silva AG, Ferreira J, Matos E, et al. Perforated peptic ulcer: main factors of morbidity and mortality. World J Surg. 2003 Jul;27(7):782–7.
14. Sule AZ, Kidmas AT, Awani K, Uba F, Misauno M. Gastrointestinal perforation following blunt abdominal trauma. East Afr Med J. 2007 Sep;84(9):429–33.
15. Agarwal N, Saha S, Srivastava A, Chumber S, Dhar A, Garg S. Peritonitis: 10 years’ experience in a single surgical unit. Trop Gastroenterol Off J Dig Dis Found. 2007 Sep;28(3):117–20.
16. Edino ST, Yakubu AA, Mohammed AZ, Abubakar IS. Prognostic factors in typhoid ileal perforation: a prospective study of 53 cases. J Natl Med Assoc. 2007 Sep;99(9):1042–5.
17. Kotan C, Sumer A, Baser M, K?z?ltan R, Carparlar MA. An analysis of 13 patients with perforated gastric carcinoma: A surgeon’s nightmare? World J Emerg Surg. 2008;3(1):17.
18. Abro A, Siddiqui FG, Akhtar S, Memon AS. Spectrum of clinical presentation and surgical management of intestinal tuberculosis at tertiary care hospital. J Ayub Med Coll Abbottabad JAMC. 2010 Sep;22(3):96–9.
19. Jain BK, Garg PK, Kumar A, Mishra K, Mohanty D, Agrawal V. Colonic perforation with peritonitis in amoebiasis: a tropical disease with high mortality. Trop Gastroenterol Off J Dig Dis Found. 2013 Jun;34(2):83–6.
20. Sharma L, Gupta S, Soin AS, Sikora S, Kapoor V. Generalized peritonitis in India--the tropical spectrum. Jpn J Surg. 1991 May;21(3):272–7.