Clinical profile of non-traumatic perforation peritonitis

Abstract

Background: Non-traumatic perforation peritonitis remains a significant surgical emergency in developing countries, with high morbidity and mortality despite advances in diagnosis and management. The condition is primarily associated with peptic ulcer disease, typhoid, tuberculosis, and malignancy.

Aim: To evaluate the clinical presentation, etiology, operative findings, postoperative complications, and outcomes of patients presenting with non-traumatic perforation peritonitis.

Methods: A prospective observational study was conducted at GSL Medical College, Rajahmundry, from March 2015 to November 2015, including 61 patients with clinically and radiologically diagnosed non-traumatic perforation peritonitis. All patients underwent emergency laparotomy, and relevant parameters were recorded and analyzed using SPSS version 20.0.

Results: Most patients were males (75.4%), aged 31–50 years (39.3%). The commonest symptom was abdominal pain (100%), followed by vomiting (82%) and abdominal distension (74%). The duodenum was the most frequent site of perforation (44.3%), followed by the ileum (32.8%) and stomach (14.8%). Wound infection (18%) was the most common postoperative complication. The mortality rate was 6.5%.

Conclusion: Duodenal perforation due to peptic ulcer disease remains the predominant cause of non-traumatic perforation peritonitis. Early diagnosis, aggressive resuscitation, and timely surgical intervention significantly improve patient outcomes.

Keywords: Non-traumatic perforation peritonitis, Duodenal ulcer, Typhoid ileal perforation, Peptic ulcer disease, Postoperative complications