One Year of Experience Managing Peritonitis Secondary to Gastrointestinal Perforation at a Tertiary Care Hospital: A Retrospective Analysis

• Published in: Curēus (Palo Alto, CA) Vol. 14; no. 4; p. e23966
• Main Authors: Shahid, Muhammad Hasaan, Khan, Faisal I, Askri, Zain, Asad, Arslan, Alam, M Azhar, Ali, Danish, Saeed, Rabia, Jamal, Aun, Fatima, Tauseef, Afzal, M Farooq
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 08.04.2022; Cureus
• Subjects: Abdomen; Analgesics; Constipation; Emergency Medicine; Fistula; General Surgery; Infectious Disease; Intensive care; Intervention; Laparoscopy; Laparotomy; Nonsteroidal anti-inflammatory drugs; Ostomy; Pain; Patients; Peritonitis; Regression analysis; Small intestine; Lahore Pakistan; Pakistan; faecal peritonitis; ileal perforation; intestinal perforation; peritonitis; duodenal perforation
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.23966

Introduction Peritonitis secondary to gastrointestinal perforation causes high morbidity and mortality rates in the emergency department with an immediate need for surgical intervention. Despite improved surgical management procedures, patients are still suffering from gastrointestinal leak causing peritonitis that demands surgical management by highly skilled surgeons in high-quality surgical units. Material and methods This paper presents one year of experience in the surgical treatment of gastrointestinal perforation-related peritonitis by surgeons in Lahore General Hospital, Lahore, Pakistan. Data was retrospectively collected from patient records and quantitatively analyzed. Involved patients developed peritonitis secondary to gastrointestinal perforation requiring surgical exploration and interventions in the emergency department between November 2020 and October 2021. Results One hundred and fifty-eight patients were involved; the mean age was 43.46 years. The number of males was 87 (55.06%). The patients mostly presented with generalized abdominal pain (57.6%). All the patients had perforation-related peritonitis, which was most prevalent in the ileum (62%). The most performed surgical intervention was loop ileostomy (36.71%). Compared to other published reports, the incidence rate of wound dehiscence in the hospital was relatively higher. Postoperatively, wound infection was low if the skin was left open (23.62%) compared to closed skin (38.7%). Patient outcomes were acceptable as the death rate was low (3.2%, 5/158). Conclusion Peritonitis caused by gastrointestinal perforation is associated with a high risk of morbidity that necessitates surgical exploration. Leaving skin wound open after the surgical intervention is recommended to decrease the incidence of wound infection and dehiscence.