Emerging Spectrum of Perforation Peritonitis in Developing World

Frontiers in Surgery

article

Tariq Hameed¹  Awadh Kumar²  Shivanand Sahni²  Rahul Bhatia³  Ajit Kumar Vidhyarthy² 

[1] Department of Surgery, Hamdard Institute of Medical Sciences & Research;Department of Surgery, Darbhanga Medical College and Hospital;Department of Surgery, Maulana Azad Medical College

关键词: Gastrointestinal tract;    perforation;    peritonitis;    etiology;    pneumoperitoneum;    exploratory laparotomy;    seasonal variation;   

DOI  :  10.3389/fsurg.2020.00050

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Gastrointestinal perforations constitute a major cause of patients with acute abdomen pain coming to the surgery emergency room. Incidence, site of perforation, and age is different in the developing world and is showing new trends. The etiological spectrum in the developing world is different from the western world. This study was conducted to find out the latest trends in perforation peritonitis in India. Methods: This study was conducted in a single surgical unit of Darbhanga Medical College and Hospital, India. A total of 350 consecutive patients with perforation peritonitis were studied in terms of age, sex, seasonal variation, biochemical parameters, clinical presentation, radiological and intraoperative findings, surgical intervention, and postoperative outcome. Results: The most common cause of perforation peritonitis in our study was a duodenal ulcer (~50%) followed by typhoid (20%), traumatic (14.5%), appendicular (7.4%), and tubercular (3.1%) cases. Males were three times more commonly affected than females. Peak incidence was noted in the 2 nd and 3 rd decades of life. Peptic ulcer perforations were common in autumn and winter and typhoid perforations were common during the summer and rainy seasons. Conclusion: Spectrum of perforation peritonitis cases in this part of world is different from developed western countries. It is different in respect of younger age at presentation, site of perforation, and etiological factors. Infective pathology makes up to a quarter of total cases in the developing world. The developing world has more perforation peritonitis cases involving the upper gastrointestinal tract, while the western world has a predominance of lower gastrointestinal tract perforations.

【 授权许可】

CC BY