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Perforation Peritonitis at High Altitude.
Bhawana Amatya1, Paleswan Joshi Lakhey2, Prativa Pandey1
1CIWEC Hospital and Travel Medicine Center, Lainchaur, Kathmandu, Nepal.
JNMA; Journal of the Nepal Medical Association
|October 31, 2018
Summary
High-altitude trekking can lead to serious gastrointestinal issues like perforations. Prompt diagnosis and evacuation are critical for survival in these rare, life-threatening cases.
Area of Science:
- Gastroenterology and Altitude Medicine
- Surgical Management of Perforations
Background:
- High-altitude environments pose risks for trekkers, including gastrointestinal symptoms attributed to acute mountain sickness or other illnesses.
- Complications of common gastrointestinal conditions can manifest at high altitudes, potentially leading to catastrophic outcomes if diagnosis is delayed.
Observation:
- Two rare cases of duodenal and gastric perforations occurred in trekkers in the Everest region.
- Both patients required emergency laparotomy for surgical repair of the perforations.
Findings:
- The first case involved a modified Graham's patch repair for a duodenal perforation.
- The second case required a distal gastrectomy with gastrojejunostomy and jejunostomy for a gastric perforation.
Implications:
- Perforation peritonitis at high altitude, while infrequent, is a life-threatening surgical emergency.
- Effective management necessitates timely evacuation from high altitude, accurate diagnosis, and prompt surgical intervention.
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