Spectrum of perforative peritonitis in Navi Mumbai : Analysis of 100 cases

Perforative peritonitis is the most common cause of emergency encountered by surgical units all over the world including India. The spectrum of etiology of perforation in asian countries differs from the western world. This study was conducted at Padmashree Dr D.Y.Patil hospital and research centre ,Navi Mumbai to highlight the spectrum of perforative peritonitis ,identify the factors influencing the mortality and morbidity and to improve the outcome. This prospective study included 100 consecutive patients of perforation studied in terms of clinical presentations, cause, site of perforation, surgical management, postoperative complications and mortality at Padmashree Dr D.Y.Patil hospital and research centre ,Navi Mumbai between January 1,2011 to May 31,2012. After establishing the diagnosis of perforative peritonitis, all patients were resuscitated and were taken for exploratory laparotomy. The most common operative finding was duodenal ulcer (55%) and appendicular perforation (16%) followed ileum (9%),intestine(9%),jejunum(5%),stomach(3%),colon(2%) and gall bladder(1%).Wound infection(10%) was the commonest complication . Overall mortality was 13%. Mortality was proportional to age, derangement of physiological parameters like hypotension, delay in surgery and as the perforation site becomes distal from duodenum to colon. Prompt resuscitation and early surgical intervention can reduce morbidity and mortality associated with peritonitis.