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Scholars Journal of Applied Medical Sciences | Volume-4 | Issue-03
Study of Spectrum of Perforation Peritonitis in Rural Area
Santosh Kumar M.B.S.C, Avinash Gurujala
Published: March 30, 2016 | 53 65
DOI: 10.36347/sjams.2016.v04i03.068
Pages: 975-980
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Abstract
Perforation peritonitis is one of the common surgical emergencies in our country, the disease which we have understood well about pathology and how to manage it. But still there were deaths due to perforation peritonitis, this warrants the need of further study on perforation peritonitis. This was a prospective study including 100 patients of perforation peritonitis, who were admitted in M.N.R Medical College and Hospital for a period of two years. All the patients were properly resuscitated, underwent surgical procedure and taken good post-operative care. In results the mean age of patients was 42.08. Most of the patients with perforation peritonitis presented to the hospital are of age >45 years. Out of the 16 cases presented after 72hrs to hospital, 10 patients (62.5%) were dead and 4 (5.56%) patients were dead out of 72 patients, who were presented in between 24 to 72hrs.Pain in the abdomen was the most common clinical feature, present in all patients. In this study, 70% cases had air under diaphragm in abdominal radiograph and 88% cases had free fluid in abdomen in ultrasound abdomen. In our study, the most common site of perforation was duodenal perforation (52%), followed by appendicular perforations (18%), gastric perforations (16%), ileal perforations (12%), and jejunal perforations (2%). Electrolyte (20%) imbalance was the most common complication, followed by pulmonary complication (18%), wound infection (16%), septicaemia (16%), wound dehiscence (12%) and intestinal obstruction (2%). The overall mortality rate was 14% in our study. The concusion in our study, the mortality rate was high in the patients, who were admitted late in the hospital. Most number of perforations was at proximal part of gastrointestinal tract than distal part of gastrointestinal tract, in contrast to developed countries.