NON APPENDICULAR PERFORATION PERITONITIS

SPECTRUM AND MANAGEMENT OUTCOME “Experience at peripheral teaching hospitals

Abstract

Objectives: To evaluate the spectrum of non-appendicular perforation peritonitis
and their management outcome in a peripheral teaching hospitals. Study design: Retrospective
descriptive, Interventional. Setting: Surgical Department Aziz Bhatti Shaheed (Teaching)
Hospital Nawaz Sharif Medical College University of Gujrat& Surgical Department Islam Medical
College Sialkot. Study period: February 2011 to June 2013. Results: All the patients with clinical
diagnosis of Acute Peritonitis were included, however patients with peritonitis secondary to
perforated appendix and traumatic GIT perforations were excluded from study when found
preoperatively. Total 100 patients with acute peritonitis were operated. 79 patients were male and
21 were female. Mean age was 39.9 years, youngest patient was a 12 year old boy whereas oldest
was 73 year old. Perforated duodenal ulcer was the commonest cause of peritonitis seen in 42
cases 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 this
complication by primary prevention, adequate& timely treatment of diseases like Peptic ulcer,
tuberculosis and Typhoid fever which are the commonest cause of GUT perforations in Eastern
region/ Tropical countries. Early diagnosis of acute peritonitis, adequate efficient resuscitation
and early exploration preferable within six hours is the key to reduce both morbidity and mortality
these patients