Publication:

Acute peritonitis secondary to hollow viscous perforation: a clinical study

Background Peritonitis due to hollow visceral perforation is commonly encountered in surgical practice it is defined as inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein. The objective of this study was to study the frequency of peritonitis secondary to hollow viscous perforation and complications of operative management.

Methods 50 cases were studied with peritonitis due to hollow viscous perforation as surgical emergencies underwent emergency laparotomy, details of age, sex, anatomical location, signs and symptoms, reliability of investigation like X-ray-abdomen, complications, mortality were noted.

Results The most common age group affected is 50 years and above. Duodenum (52%) is the most common site of perforation followed by ileal perforation (26%) appendicular (14%) and colonic perforation (4%). 84% of the patients were male patients and 16% of the patients were females. Duodenal ulcer (52%) is the most common cause of perforative peritonitis followed by small intestinal perforation. The appendicular perforation forms the next commonest cause of perforation (14%). Guarding and rigidity was present in 90% of patients. Diagnosis is made clinically and confirmed by presence of pneumoperitoneum (76%) on radiographs. Laparotomy with closure of the perforation with omental patch (64%) is the commonest operative management for perforated peptic ulcer fallowed by simple closure, resection and anastomosis, and loop ileostomy. The most common postoperative complication observed was lower respiratory tract infection. Overall mortality rate was 8%. The average duration of stay in hospital is 12.44 days.

Conclusions Laparotomy with closure of the perforation with omental patch closure is the commonest method of surgical management in perforative peritonitis due to hollow viscous perforation.