Non Appendicular Perforation Peritonitis ; Spectrum and Management

.. Objectives: To evaluate the spectrum of non-appendicular perforation peritonitis and their management outcome in a peripheral teaching hospitals. Study design: Retrospective descriptive, Interventional. Setting: Surgical Department Aziz Bhatti Shaheed (Teaching) Hospital Nawaz Sharif Medical College University of Gujrat& Surgical Department Islam Medical College Sialkot. Study period: February 2011 to June 2013. Results: All the patients with clinical diagnosis of Acute Peritonitis were included, however patients with peritonitis secondary to perforated appendix and traumatic GIT perforations were excluded from study when found preoperatively. Total 100 patients with acute peritonitis were operated. 79 patients were male and 21 were female. Mean age was 39.9 years, youngest patient was a 12 year old boy whereas oldest was 73 year old. Perforated duodenal ulcer was the commonest cause of peritonitis seen in 42 cases followed by intestinal tuberculosis 18%. Enteric gut perforation was seen in 17% cases. Mortality was 9% and sepsis and multi organ failure was the main cause of death. Conclusions: Management of perforation peritonitis is a complex and demanding. We can avoid this complication by primary prevention, adequate& timely treatment of diseases like Peptic ulcer, tuberculosis and Typhoid fever which are the commonest cause of GUT perforations in Eastern region/ Tropical countries. Early diagnosis of acute peritonitis, adequate efficient resuscitation and early exploration preferable within six hours is the key to reduce both morbidity and mortality these patients