1Professor, Department of Community Medicine, Sree Mookambika Institute Of Medical Sciences, Kulasekharam
2Assistant Professor, Department of General Surgery, Sree Mookambika Institute Of Medical Sciences, Kulasekharam
3Assistant Professor, Department of Community Medicine, Sree Mookambika Institute Of Medical Sciences, Kulasekharam
*Corresponding author-Dr. Vishnu G Ashok, Assistant Professor Department of Community Medicine, Sree Mookambika Institute of Medical Sciences, Kulasekharam
Online published on 2 September, 2017.
Peritonitis in simple words defined as an inflammation of the peritoneum belies the life threatening nature of the disease. It forms one of the commonest causes of acute abdomen presenting to the emergency department. Peritonitis is defined as an inflammatory process of the peritoneum caused by any irritant/agent such as bacteria, fungi, virus, talc, drugs, granulomas, and foreign bodies. Intra-abdominal infection is defined as the local manifestations that occur as a consequence of peritonitis. Intra-abdominal sepsis entails a systemic manifestation of a severe peritoneal inflammation. The clinical spectrum of peritonitis may also be classified according to the pathogenesis as primary, secondary, or tertiary peritonitis.
To study the microbial flora in cases of peritonitis following perforation of the viscera, to identify the various pathogens & their relation to the area perforated, to analyze the clinical features in relation to the pathogens encountered and to study the proper selection of antibiotics & and their effective use
A prospective study was carried out in the surgical casualty of a tertiary care centre. Cases presenting to the surgical casualty with features of perforation peritonitis who have been confirmed of the diagnosis by laparotomy were included. Patients who presented with primary peritonitis, Peritonitis due to anastomotic leak and Patients already on antibiotics from elsewhere were excluded
Out of the 158 study participants majority are males (84.8%). Most common site of perforation in the descending order duodenum(43%) > appendix(17.7%) > gastric (14.6%) ileum(11.4%). Most common cause of perforation was found to be peptic ulcer (56%). Post operative period was uneventful in 32% of participants among the others 40% developed wound infection followed by 24% developed respiratory tract infect. Mortality rate among the patients undergone surgery during the postoperative period was 15%
Most common cause of perforation peritonitis is perforation of peptic ulcers. Of these duodenal ulcer perforations are the most common.
Peritonitis, Perforation, Microbial Flora
