The surgical management of peritonitis secondary to hollow VISCUS perforation

Abstract

Peritonitis requires emergency surgical intervention and is associated with significant morbidity and mortality rates. The presence of pneumoperitoneum on radiographs is confirmatory of viscus perforation. The definitive diagnosis should be arrived at the shortest period of time with available investigations. Cases of peritonitis secondary to hollow viscus perforation undergoing emergency laparotomy was assessed for the site of perforation, its pathological condition and the amount of peritoneal contamination. Depending on the site of perforation and pathological condition, appropriate procedure will be adopted for its management, that includes omental patch closure, simple closure, open appendectomy, resection anastomosis and loop ileostomy. Postoperatively patients was examined for the development of any complications. The procedure performed intraoperatively depended upon the
operating surgeon and the site of perforation noted in situ. For all the cases with duodenal and gastric perforation omental patch repair was done. Simple closure and resection of the bowel was done for ileal perforations. Resection and anastomosis was also done in a case of ileal diverticulitis with perforation. Our study had 5 subjects with perforation secondary to colonic malignancy of which three of them were operated for right hemicolectomy and two proceeded with ileostomy