Clinical spectrum, surgical management, and outcomes of non-traumatic perforation peritonitis: A prospective study from South India

Abstract

Background: Non-traumatic perforation peritonitis remains a common surgical emergency in India, contributing substantially to morbidity and mortality. Despite advances in critical care and antimicrobial therapy, delayed presentation continues to worsen clinical outcomes.

Aim: To evaluate the clinical profile, etiology, management, and postoperative outcomes of patients with non-traumatic perforation peritonitis.

Methods: A prospective observational study was conducted in the Department of General Surgery, GSL Medical College, Rajahmundry, from January 2018 to June 2018, involving 61 patients diagnosed with non-traumatic perforation peritonitis. Clinical, biochemical, radiological, and operative data were recorded. All patients underwent exploratory laparotomy with appropriate surgical procedures based on site and cause of perforation. Data were analyzed using SPSS version 21.0, with p<0.05 considered statistically significant.

Results: Males predominated (75.4%) with a mean age of 42.6 years. The duodenum (42.6%) and ileum (29.5%) were the most common perforation sites. Omental patch repair (42.6%) was the most frequent procedure. Postoperative wound infection (29.5%) was the leading complication, and overall mortality was 9.8%, significantly associated with delayed presentation and sepsis.

Conclusion: Early diagnosis, aggressive resuscitation, timely surgery, and infection control are essential to reduce complications and mortality in perforation peritonitis.

Keywords: Perforation peritonitis, Duodenal ulcer, Ileal perforation, Omental patch repair, Sepsis