%0 Journal Article
%T Perforation Peritonitis and the Developing World
%A Rajandeep Singh Bali
%A Sushant Verma
%A P. N. Agarwal
%A Rajdeep Singh
%A Nikhil Talwar
%J ISRN Surgery
%D 2014
%R 10.1155/2014/105492
%X Background. Perforation peritonitis is the one of the commonest emergency encountered by surgeons. The aim of this paper is to provide an overview of the spectrum of perforation peritonitis managed in a single unit of a tertiary care hospital in Delhi. Methods. A retrospective study was carried out between May 2010 and June 2013 in a single unit of the department of Surgery, Lok Nayak Hospital, Delhi. It included 400 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included. Results. The commonest cause of perforation peritonitis included 179 cases of peptic ulcer disease (150 duodenal ulcers and 29 gastric ulcers) followed by appendicitis (74 cases), typhoid fever (48 cases), tuberculosis (40 cases), and trauma (31). The overall mortality was 7%. Conclusions. Perforation peritonitis in India has a different spectrum as compared to the western countries. Peptic ulcer perforation, perforating appendicitis, typhoid, and tubercular perforations are the major causes of gastrointestinal perforations. Early surgical intervention under the cover of broad spectrum antibiotics preceded by adequate aggressive resuscitation and correction of electrolyte imbalances is imperative for good outcomes minimizing morbidity and mortality. 1. Introduction Gastrointestinal perforations constitute one of the commonest surgical emergency encountered by surgeons [1, 2]. Management of these patients continues to be highly demanding despite the advances made in diagnosis and surgical therapy. The etiological spectrum of perforation peritonitis in India differs significantly from its western counter parts [3¨C5]. Our study was carried out to highlight the spectrum of perforation peritonitis (diffuse) in a single unit at Lok Nayak Hospital, a tertiary care hospital in Delhi. 2. Patients and Methods The retrospective study was conducted at the Department of Surgery, Maulana Azad Medical College and associated Lok Nayak Hospital, Delhi, from May 2010 to June 2013. The study population included 400 patients of perforation peritonitis (diffuse or localized) presenting to the surgical emergency of Lok Nayak Hospital, Delhi, who underwent exploratory laparotomy. Cases were studied with respect to clinical features at the time of presentation, comorbid conditions, radiological investigations, operative findings, and postoperative course. After establishing
%U http://www.hindawi.com/journals/isrn.surgery/2014/105492/