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Perforation peritonitis and the developing world.

Rajandeep Singh Bali1, Sushant Verma2, P N Agarwal1

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Summary
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Perforation peritonitis in India is commonly caused by peptic ulcers, appendicitis, typhoid, and tuberculosis. Early surgical intervention and resuscitation are crucial for improving outcomes in these emergency surgical cases.

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Area of Science:

  • Gastroenterology
  • Surgical Emergency
  • Public Health

Background:

  • Perforation peritonitis is a frequent surgical emergency.
  • Understanding its spectrum in India is vital for effective management.
  • Tertiary care centers manage diverse cases.

Purpose of the Study:

  • To present an overview of perforation peritonitis cases.
  • To analyze causes, surgical treatments, and outcomes.
  • To compare the Indian spectrum with Western data.

Main Methods:

  • Retrospective study of 400 patients.
  • Conducted at a tertiary care hospital in Delhi (May 2010 - June 2013).
  • Included patients undergoing exploratory laparotomy for perforation peritonitis.

Main Results:

  • Peptic ulcer disease was the leading cause (179 cases).
  • Other significant causes included appendicitis (74), typhoid (48), and tuberculosis (40).
  • Overall mortality rate was 7%.

Conclusions:

  • The spectrum of perforation peritonitis in India differs from Western countries.
  • Key causes are peptic ulcer, appendicitis, typhoid, and tubercular perforations.
  • Prompt surgical intervention with antibiotics and resuscitation is essential.