Aetiology and Outcomes of Secondary Peritonitis in a Suburban Teaching Hospital in Nigeria: A Prospective Study

Secondary peritonitis is a common surgical emergency in the developing world. It is associated with high morbidity and mortality rates despite advancements in treatment. This study aimed to determine the causes and treatment outcomes of secondary peritonitis following gastrointestinal perforation in a suburban Nigerian teaching hospital.

This prospective study was conducted over one year, enrolling 64 patients with secondary peritonitis due to gastrointestinal perforation. Sociodemographic and clinical data were collected, and samples were analysed using standard procedures. Statistical analysis was performed using STATA software version 16.

The study included 64 patients who met the inclusion criteria, 43 (67.19%) males and 21 (32.81%) females, with a male-to-female ratio of 2:1 and a mean age of 41.21± 2.79 years. Only 4 (6.25%) patients presented within 24 hours of the onset of symptoms, while 14 (21.88%) patients presented in shock. Gastroduodenal perforation (42.2%), ruptured appendicitis (37.5 %), and typhoidal perforation (12.5 %) were the main causes of secondary peritonitis. Complications occurred in 29.7% of patients, with surgical site infections being the most common. The mortality rate was 10.9 %, with comorbidities (p=0.005) and postoperative complications (p=0.004) significantly associated with outcomes.

Common causes of secondary peritonitis following gastrointestinal perforation in this study were gastroduodenal perforation, ruptured appendicitis, and typhoidal perforation. Postoperative complications were linked to mortality, emphasizing the importance of prompt evaluation and resuscitation to prevent complications. Only associations, not predictors, were identified. The limitation of this study is the relatively small sample size, which limits the generalizability of the findings to the Nigerian population. Consequently, larger, preferably multicenter studies are recommended.