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Evaluating the Correlation between Elevated Intra-abdominal Pressure and Outcomes of Perforation Peritonitis: An

Jaspreet Singh Shergill1, Harmandeep Singh Jabbal1, Jyoti Sharma2

  • 1Department of General Surgery, AIIMS, Bathinda, Punjab, India.

Annals of African Medicine
|July 2, 2026
PubMed

Insights

Elevated intra-abdominal pressure (IAP) in perforation peritonitis showed uncertain correlations with postoperative morbidities like surgical site infection and wound dehiscence. Further research with larger sample sizes is needed to clarify these findings.

Area of Science:

  • Abdominal Surgery
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Perforation peritonitis frequently causes elevated intra-abdominal pressure (IAP), a condition linked to impaired organ perfusion, multi-organ failure, and mortality.
  • Despite its known complications, elevated IAP remains underdiagnosed in clinical practice.
  • This study investigates the relationship between increased IAP and postoperative complications following perforation peritonitis.

Purpose of the Study:

  • To correlate postoperative morbidities in patients with perforation peritonitis with measured intra-abdominal pressure (IAP).
  • To identify specific complications associated with elevated IAP in this patient population.

Main Methods:

  • An observational study involving 55 patients with perforation peritonitis who underwent emergency laparotomy or drain placement.
  • Intra-abdominal pressure (IAP) was indirectly measured using Foley's catheter to determine urinary bladder pressure.
  • Postoperative morbidities including surgical site infection (SSI), wound dehiscence, burst abdomen, prolonged ileus, ARDS, and ARF were recorded and correlated with IAP using Spearman's correlation coefficient.

Main Results:

  • The mean preoperative IAP was 27.4 ± 3.6 cm H2O.
  • Surgical site infection (SSI) was the most common morbidity (41%), followed by wound dehiscence (27%) and ARDS (21%).
  • A direct correlation was found between IAP and SSI, wound dehiscence, and prolonged ileus; inverse correlations with burst abdomen, ARDS, and ARF were not statistically significant.

Conclusions:

  • The study found an uncertain correlation between elevated IAP and postoperative outcomes in perforation peritonitis.
  • While some morbidities showed direct correlations with IAP, these were not statistically significant.
  • Larger sample sizes are recommended for future studies to further elucidate the relationship between IAP and perforation peritonitis outcomes.
Abstract

Keywords:
CorrelationPression intra-abdominalecorrélationduodenum perforationsinfection du site opératoireintra-abdominal pressuremorbidités postopératoiresperforation peritonitisperforations duodénalespostoperative morbiditiespéritonite par perforationsurgical site infection

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