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Perforation peritonitis and the developing world.
[typhoid]
Background
.
Perforation
peritonitis
is
the
one
of
the
commonest
emergency
encountered
by
surgeons
.
The
aim
of
this
paper
is
to
provide
an
overview
of
the
spectrum
of
perforation
peritonitis
managed
in
a
single
unit
of
a
tertiary
care
hospital
in
Delhi
.
Methods
.
A
retrospective
study
was
carried
out
between
May
2010
and
June
2013
in
a
single
unit
of
the
department
of
Surgery
,
Lok
Nayak
Hospital
,
Delhi
.
It
included
400
patients
of
perforation
peritonitis
(
diffuse
or
localized
)
who
were
studied
retrospectively
in
terms
of
cause
,
site
of
perforation
,
surgical
treatment
,
complications
,
and
mortality
.
Only
those
patients
who
underwent
exploratory
laparotomy
for
management
of
perforation
peritonitis
were
included
.
Results
.
The
commonest
cause
of
perforation
peritonitis
included
179
cases
of
peptic
ulcer
disease
(
150
duodenal
ulcers
and
29
gastric
ulcers
)
followed
by
appendicitis
(
74
cases
)
,
typhoid
fever
(
48
cases
)
,
tuberculosis
(
40
cases
)
,
and
trauma
(
31
)
.
The
overall
mortality
was
7
%
.
Conclusions
.
Perforation
peritonitis
in
India
has
a
different
spectrum
as
compared
to
the
western
countries
.
Peptic
ulcer
perforation
,
perforating
appendicitis
,
typhoid
,
and
tubercular
perforations
are
the
major
causes
of
gastrointestinal
perforations
.
Early
surgical
intervention
under
the
cover
of
broad
spectrum
antibiotics
preceded
by
adequate
aggressive
resuscitation
and
correction
of
electrolyte
imbalances
is
imperative
for
good
outcomes
minimizing
morbidity
and
mortality
.
Diseases
Validation
Diseases presenting
"early surgical intervention under the cover"
symptom
typhoid
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