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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
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated
