Clinico-pathological study of non-traumatic hollow viscus perforation in tertiary care hospital

Author: 
Dr. Subhash Sharma, Dr. Kunal Malhotra, Dr. Ashok Kumar Kaundal and Dr. Anil Malhotra

Peritonitis due to perforation of viscus, either traumatic or non-traumatic is an important cause of morbidity and mortality in an emergency. Remarkably, however, only within the last century has significant progress been made in the successful treatment of the disease. The reduction in mortality from 90% at the turn of the century to the estimated 10-15% also includes support of improved and effective antibiotics along with our understanding of inflammatory respo. Nse & there is also a need to know the spectrum of presentation as well as the most frequent among them. Peritonitis as such has such diverse aetiology and thus there is a need to enlist the different a etiologies leading to the disease.
Objectives: The purpose of this study was to evaluate the relative incidence of various causes of perforation and also to find its relation to age, group and sex of the patient. Importance has also been given to the clinical presentation, relevant investigations and various modalities of treatment.
Materials and methods: This study has been based on the analysis of 200 cases of gastrointestinal perforation admitted toin single surgical unit of deptt. of surgery, I.G.M.C Shimla from1st Aug, 2013 to 31st July2018.
Observation: Out of 200 patients presented to emergency department with features of perforation peritonitis,132 patients (66%) of them were found to have peptic ulcer perforation. This was followed by appendicular perforation (9%). Tubercular perforation is relatively rare. Mortality rate was found to be12%, the cause of which was diagnosed as septicaemia.
Conclusion: Surgery is the line of management of perforation peritonitis. Early diagnosis with appropriate investigations and treatment with antibiotics, fluid and electrolyte balance and exploratory laparotomy is always advocated for better patient compliance and relatively low mortality.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2020. 22979.4542
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