International J. of Healthcare and Biomedical Research, Volume: 2, Issue: 3 , April 2014 , Pages 201-209
Original article:
A study of traumatic perforation peritonitis in a rural medical
college hospital with identification of risk factors.
Dr. S. H. Kulkarni
Professor of Surgery, Bharati Vidyapeeth Deemed University
Bharati Medical College & Hospital, Sangli, Maharashtra , India ‘
Corresponding author : Email- shk1945@rediffmail.com
Abstract:
Background: Traumatic accidents are on the rise in developing countries. Rural medical colleges need to be
geared up to deal with these cases. Abdominal trauma form an important cause of mortality. This study aims
to identify the causes of mortality in traumatic gastrointestinal perforations.
Methodolgy : One hundred and two cases of perforation peritonitis due to trauma are analysed. The type of
trauma, age of the patient, time duration between trauma and hospitalization, presence of shock on admission,
associated pre-existing illness, site of perforation and its treatment, and postoperative complications were
noted. The risk factors to mortality were evaluated using chi-square test and p-value.
Results : The incidence of trauma was more in males and in younger age group of 21 to 40 years. Seventy
one patients had blunt and thirty one had penetrating trauma. Ileal perforation was the most common i.e. 48
cases followed by jejunal 29, colonic 10, gastric 8, duodenal 5 and rectum 2. Twelve patients out of 22 above of
fifty succumbed; six patients expired out of eleven patients who had delayed admission. Eight patients had preexisting illness out of which six expired. Ten patients expired out of eighteen who were admitted in shock.
Presence of pelvic or spine fractures increased the mortality as three out of five patients expired. Nine out of eleven
patients expired who had post operative complications. However, the mortality did not depend upon the type of
trauma blunt or sharp.
Conclusion : The statistical analysis showed that age more than 50 years, pre-existing illness, delayed
hospitalization, shock on admission, associated pelvic or spine injury and post-operative complications are the
predominant risk factors for mortality.
Keywords: Gastrointestinal Perforation, Peritonitis