Study of Perforation Peritonitis at a Tertiary Center of Northern Tribal Belt of Chhattisgarh.

Author(s): Dr. Ramesh Chandra Arya,

BACKGROUND Perforation peritonitis is one of the commonest surgical emergencies in clinical practice and often life threatening if left untreated. Post-operative complication rate is found to be high in our study, may be due to late presentation to the tertiary health center and co-morbid conditions of the patients. We wanted to evaluate the various clinical presentations, sites of perforation, surgical treatment, outcomes, postoperative complications and mortality of perforation peritonitis. METHODS This is an observational study conducted among referral cases in a tertiary care center- Government Medical College, Ambikapur, Chhattisgarh, and data collected included age, sex, clinical presentation, risk factors, radiological findings, operative findings and postoperative course of treated patients. RESULTS Out of 108 cases of perforation peritonitis studied, 80 (74.07%) were of gastric perforation, 14 (12.96%) were of duodenal perforation, 9 (8.33%) were of appendicular perforation and remaining 5 (4.62%) were of ileal perforation. Common surgery done was primary closure with omentopexy in 82 (75.92%) patients, simple primary closure was done in 16 (14.81%) patients, appendicectomy done in 9 (8.33%) patients and remaining 1 (0.92%) patient was treated with ileostomy. CONCLUSIONS Gastric perforation is found to be the most common cause of gastro-intestinal perforation leading to peritonitis. Gastric perforation was found to be more common than duodenal perforation. Late presentation to hospital is commonly associated with complications which could have been avoided with early diagnosis and aggressive treatment initiated in time.