Clinical findings and postoperative management in perforative peritonitis

Abstract

Background and Objectives: The exudates of peritonitis although helps by attacking bacteria and their toxins, unfortunately becomes distributed overate peritoneal cavity and tends to disseminate the infection. The present study was performed to elucidate the operative procedures, postoperative management in peritonitis as per the plain X-ray investigation. Materials and Methods: This study was conducted after the institutional ethical clearance and informed written consent from all the subjects. Fifty surgically proved perforative peritonitis cases admitted to the surgical wards were included in the study. The nature of peritoneal exudates, bacteriological culture, sensitivity tests for microorganisms, operative procedures and the postoperative management was done in all the cases. The percentage mortality was also recorded. The data are expressed as mean and the percentile was calculated in each parameters. Results : The nature of peritoneal exudates was found to be predominantly bile stained. In most of the cases used ciprofloxacin and metrogyl. All the peptic ulcer perforations were closed with omental graft. The Postoperative management was done in all the patients and majority (38%) of them have exhibited stitch abscess due to wound infection. There were seven deaths in the series of fifty perforative peritonitis cases hence; the overall mortality was 14%. Conclusion : The operative procedures that were adopted were simple closure of the perforation, closure with omental patch, vagotomy with HeineKe-Mikulicz pyloroplasty with closure of perforation, resection and anastomosis and appendicectomy.