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One Year of Experience Managing Peritonitis Secondary to Gastrointestinal Perforation at a Tertiary Care Hospital: A
Muhammad Hasaan Shahid1, Faisal I Khan2, Zain Askri1
1General Surgery, Lahore General Hospital, Lahore, PAK.
Insights
Gastrointestinal perforation leading to peritonitis requires emergency surgery. Leaving surgical wounds open post-operation can reduce infection and dehiscence rates, improving patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Emergency Medicine
- Infectious Disease
Background:
- Peritonitis secondary to gastrointestinal perforation presents significant morbidity and mortality.
- Prompt surgical intervention is critical for managing emergency department cases.
Purpose of the Study:
- To evaluate the surgical treatment outcomes for gastrointestinal perforation-related peritonitis.
- To assess the impact of wound management on postoperative complications.
Main Methods:
- Retrospective analysis of 158 patients undergoing surgical treatment for peritonitis due to gastrointestinal perforation.
- Data collected from November 2020 to October 2021 at Lahore General Hospital.
- Surgical interventions included loop ileostomy; wound management strategies were compared.
Main Results:
- The most common site of perforation was the ileum (62%).
- Wound infection rates were lower when surgical skin wounds were left open (23.62%) versus closed (38.7%).
- The overall mortality rate was 3.2%.
Conclusions:
- Gastrointestinal perforation-induced peritonitis necessitates surgical exploration due to high morbidity risks.
- Leaving surgical wounds open is recommended to decrease postoperative wound infection and dehiscence.
Abstract:
Introduction Peritonitis secondary to gastrointestinal perforation causes high morbidity and mortality rates in the emergency department with an immediate need for surgical intervention. Despite improved surgical management procedures, patients are still suffering from gastrointestinal leak causing peritonitis that demands surgical management by highly skilled surgeons in high-quality surgical units. Material and methods This paper presents one year of experience in the surgical treatment of gastrointestinal perforation-related peritonitis by surgeons in Lahore General Hospital, Lahore, Pakistan. Data was retrospectively collected from patient records and quantitatively analyzed. Involved patients developed peritonitis secondary to gastrointestinal perforation requiring surgical exploration and interventions in the emergency department between November 2020 and October 2021. Results One hundred and fifty-eight patients were involved; the mean age was 43.46 years. The number of males was 87 (55.06%). The patients mostly presented with generalized abdominal pain (57.6%). All the patients had perforation-related peritonitis, which was most prevalent in the ileum (62%). The most performed surgical intervention was loop ileostomy (36.71%). Compared to other published reports, the incidence rate of wound dehiscence in the hospital was relatively higher. Postoperatively, wound infection was low if the skin was left open (23.62%) compared to closed skin (38.7%). Patient outcomes were acceptable as the death rate was low (3.2%, 5/158). Conclusion Peritonitis caused by gastrointestinal perforation is associated with a high risk of morbidity that necessitates surgical exploration. Leaving skin wound open after the surgical intervention is recommended to decrease the incidence of wound infection and dehiscence.
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