CAUSES, CLINICAL PRESENTATION AND OUTCOME OF SECONDARY GENERALIZED PERITONITIS IN ADULT SURGICAL PATIENTS

Abstract

ABSTRACT INTRODUCTION: Peritonitis is a life-threatening condition with a multitude of etiologies that can vary with geographic location. Despite a better understanding of pathophysiology, advances in diagnosis, surgery, antimicrobial therapy and intensive care support, peritonitis remains a potentially fatal affliction. OBJECTIVE: To determine the causes, clinical presentation and outcome of secondary Generalized peritonitis in adult surgical patients at SPHMMC, Addis Ababa, Ethiopia, from September 2015 – August 2016 G.C. Methodology: -The study employed a retrospective design. Study subjects were identified from the hospital admission/discharge records, patient cards and operation log books which were collected by pretested data collection format by trained final year medical students. Data analyzed using SPSS software. The analyzed data presented using tablesand described using texts. RESULTS A total of 186 patients were studied. Most of the patients were males; with male to Female ratio of 2.3:1. Majority of the patients presented with pain (100%) associated with bowel symptoms. The most common etiologies were appendicular perforation 57(30.6%) ,Gastro duodenal perforation 43(23.1%),Gangrenous SBO 17(9.14%),Traumatic perforation of small bowel 14(7.5%),Gangrenous Sigmoid volvulus 15(8%),Stomach perforation 8(4.3%),Ileosigmoid knotting 6(3.2%),Tumor perforation 6(3.2%) and others 19(10.2%). Ex lap + Appendectomy + Lavage was the most commonly performed procedure. Overall morbidity was 36% and mortality was 11% CONCLUSION & RECOMMENDATION Generalized peritonitis is a common and significant surgical problem in Ethiopia. The most affected group was the young individuals who are most involved in social productivity and thus has an impact on the economy of the society. Parameters such as aggressive fluid and electrolyte resuscitation with vital sign monitoring, type of surgical procedures and use of appropriate antibiotics use should be emphasized in order to improve survival.