MPI score assessment of perforation peritonitis patients

The most widespread clinical emergency in India is perforation peritonitis. Following improvements in operational procedures, antimicrobial treatments, and care in ICUs, peritonitis control is often very complicated, complicated, and challenging. MPI provides the highest precision of risk-assessment such that specific predictions for patients with peritonitis could be estimated. The objective of this research is to determine the prognosis for perforated peritonitis patients using the peritonitis index from Mannheim. It is also targeted at a) assessing the results in Mannheim peritonitis test perforation cases b) evaluating elevated incidents of perforated peritonitis on the Peritonitis Scale with Mannheim. C) Determining the function of the Mannheim Peritonitis Index in decision-making on peritonitis surgery. This research measured the diagnosis of perforated peritonitis patients utilizing peritonitis score of Mannheim’s Index. In the present study, we observed that the majority of the study subjects were males (65.38%), and many of the cases ranged from the age group of 46-55 years (25%), as well as 36-45 years (23.07%). The majority of the cases had duodenal perforation (42.30%), followed by gastric perforation (28.84%), appendicular perforation (13.46%), filial perforation (9.61%), jejunal (3.8%), colonic perforation (1.9%). We observed that the majority of the study subjects reported the MPI score between 21-29 (46.15%), followed by (38.46%) cases who reported MPI score of more than 29, and 15.38% who reported MPI score less than 21.

SPECTRUM OF PERFORATION PERITONITIS IN WESTERN NEPAL

Introduction: Despite advances in surgical technique, antimicrobial therapy and perioperative care morbidity and mortality in perforated peritonitis is still high. Aim of this study was to highlight the clinical presentation, intra operative findings and postoperative complications and mortality among patient who has undergone emergency surgery for perforated peritonitis in tertiary care center in western Nepal.Materials and Methods: This was a retrospective descriptive study carried out in Universal College of Medical Sciences, Bhairawha, Nepal. All patients who underwent emergency exploratory laparotomy for perforated peritonitis in one year period (from April 2014 to March 2015) were included in the study.Results: Total 90 cases met inclusion criteria and were analyzed. Most common presenting symptom was pain abdomen. Pneumoperitoneum was seen in 86 (95.6%) patients. Most common site of perforation was prepyloric perforation followed by duodenum. Most common cause of perforation was Acid peptic disease. Most common surgical procedure performed was Omentopexy. There were total of 11 (12.2%)mortality.Conclusion: The spectrum of perforation peritonitis in our study differs from western countries whereas it is similar to that of other research from Indian subcontinent. Majority of perforations are noticed in the duodenum and stomach due to acid-peptic disease and small bowel typhoid followed by trauma. Overall mortality was seen in 12.2%.Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 11-13

Etiology and complications of perforated peritonitis: a retrospective study

Background: Peritonitis caused by perforation of the gastrointestinal tract is one of the most common emergencies in surgery and therefore required immediate recognition and management. The spectrum of this disease if different in India compared to the other parts of the world. Thus, this study was undertaken to assess the risk factors and outcome of this condition in the area.Methods: Forty-three patients, between 10-70 years, who had undergone treatment for perforated peritonitis either as an emergency or as an elective procedure were included into this retrospective study. Records of the inpatients were obtained from the medical records department of the hospital. Abdominal X-ray and abdominal and pelvic ultra sound was done for all the patients. Metronidazole and cefotaxime were given intravenously for all the patients. Records of the inpatients were obtained from the medical records department of the hospital.Results: Out of the 43 patients under study, 79% were males and 21% were females. The most predominant age group to be affected was 41-50 years followed by 51-60 years. 72.1% of the patients were alcohol users, 58.1% were smokers and 18.6% were on NSAIDs use. All the patients presented with abdominal pain and tenderness, followed by nausea and vomiting, presence of free fluid ad constipation. The most common cause for perforated peritonitis was peptic ulcers (58.1%), followed by enteric fever (16.3%), Tubercular peritonitis and ischemic bowel syndrome (7% each). Wound infections and electrolyte imbalance were the most common complications observed.Conclusions: Surgical peritonitis is one of the most common surgical emergency procedures performed. Since there is no way to prevent the peritonitis, the most effective treatment would be with the help of efficient and prompt surgery, with modern anesthesia and proper post-operative care. This would help to reduce the morbidity and mortality among the patients.