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A Study on Causes and Complications of Acute Peritonitis

Arunkumar Tukaram, Assistant Professor, Department of Surgery, ESIC Medical College, Gulbarga, Karnataka-585106, India. , Zaheeruddin Athera , Arunkumar Tukarama

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New Indian Journal of Surgery 8(3):p 421-425, Jul-Sep 2017. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8317.23

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Abstract

Introduction: Peritoneum becomes inflamed secondary to bacterial invasion or chemical insult. Pathogenic organisms reach the peritoneal cavity through viscus perforation, through intraperitoneal visceral suppuration, from abdominal wound, through the blood, lymphatics or via open ends of fallopian tubes. Chemical peritonitis results from blood, bile gastric fluids, or foreign bodies left after surgery like glove lubricant such as talc, cellulose fibres from gauze pads, drapes and gown. Peritonitis may be acute or chronic, septic or aseptic, primary or secondary, localized or generalized.

Methodology: Cases clinically diagnosed as peritonitis underwent X-ray erect abdomen, and blood investigations like CBC, Blood urea, serum creatinine, urine routine and microscopy. Serum amylase and widal test was done if pancreatitis or enteric fever was suspected respectively. After stabilization, patients were taken up for surgery. Laparotomy was done under general anaesthesia or epidural anaesthesia.

Results: Duodenal ulcer perforations were closed using omental patch (Grahms patch). All appendicular perforation cases underwent appendicectomy. All cases of gastric perforation were closed with simple closure only. Jejunal and ileal perforations were closed with simple closure only. One case of sealed ileal perforation was treated with peritoneal toilet. One case of colonic perforation underwent resection of gangrenous part and transverse colostomy. All cases underwent peritoneal lavage and drainage after surgery.

Conclusion: Wound infection is a most common postoperative complication.

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8317.23

Keywords

Peritonitis; Peritoneal Lavage; E.Coli. 

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