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    Journal Reading PERITONITIS - Suci Risa Novi

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    kresna adhi
    This study examined factors predicting mortality from peritonitis. The authors found that proximal gastrointestinal tract perforations were more common than distal perforations, likely due to decreased rates of peptic ulcer disease in developed countries. Mortality was highest for patients with purulent/fecal contamination, proximal perforations, abdominal abscesses, pneumonia, advanced age, hypotension/tachycardia, and abnormal white blood cell counts. The authors concluded that early surgery and aggressive pre- and post-operative care are needed to reduce mortality from peritonitis.

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    Journal Reading PERITONITIS - Suci Risa Novi

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    kresna adhi
    24 views18 pages
    This study examined factors predicting mortality from peritonitis. The authors found that proximal gastrointestinal tract perforations were more common than distal perforations, likely due to decreased rates of peptic ulcer disease in developed countries. Mortality was highest for patients with purulent/fecal contamination, proximal perforations, abdominal abscesses, pneumonia, advanced age, hypotension/tachycardia, and abnormal white blood cell counts. The authors concluded that early surgery and aggressive pre- and post-operative care are needed to reduce mortality from peritonitis.

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    Journal Reading PERITONITIS_Suci Risa Novi

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    This study examined factors predicting mortality from peritonitis. The authors found that proximal gastrointestinal tract perforations were more common than distal perforations, likely due to decreased rates of peptic ulcer disease in developed countries. Mortality was highest for patients with purulent/fecal contamination, proximal perforations, abdominal abscesses, pneumonia, advanced age, hypotension/tachycardia, and abnormal white blood cell counts. The authors concluded that early surgery and aggressive pre- and post-operative care are needed to reduce mortality from peritonitis.

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    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    24 views18 pages

    Journal Reading PERITONITIS - Suci Risa Novi

    Uploaded by

    kresna adhi
    This study examined factors predicting mortality from peritonitis. The authors found that proximal gastrointestinal tract perforations were more common than distal perforations, likely due to decreased rates of peptic ulcer disease in developed countries. Mortality was highest for patients with purulent/fecal contamination, proximal perforations, abdominal abscesses, pneumonia, advanced age, hypotension/tachycardia, and abnormal white blood cell counts. The authors concluded that early surgery and aggressive pre- and post-operative care are needed to reduce mortality from peritonitis.

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    You are on page 1of 18

    ETIOLOGY OF PERITONITIS AND FACTORS

    PREDICTING
    THE MORTALITY IN PERITONITIS
    Jeetendar J Paryani, Vikas Patel, Gunvant Rathod

    Oleh:
    RISA UTAMI (I11108039)
    NOVI ERVINA (I11109009)
    SUCI PURNAMASARI (I11109023)

    Pembimbing:
    dr. ZEPRI SITORUS, Sp. B

    SMF BEDAH RSUD dr. ABDUL AZIZ SINGKAWANG


    FAKULTAS KEDOKTERAN
    UNIVERSITAS TANJUNGPURA
    PONTIANAK
    2015
    1
    INTRODUCTION

    2
    PERITONITIS
    inflammation of peritoneum

    • most commonly due to generalized or localized infection


    • Primary peritonitis rarely requires any surgical treatment.
    • Secondary peritonitis can be due to perforation of bowel
    • High morbidity and mortality resulting from delayed
    presentationexpresses a gap that can be filled by
    improvement in care through a better ability to recognize
    and treat peritonitis

    3
    METHODS

    4
    Study setting Data collection Analysis of
    data
    • conducted at • Patients admitted • variables were
    the Civil to Civil Hospital, compared in
    who underwent an
    hospital and operation for two groups:
    B.J Medical treatment of expired (group
    College peritonitis A) and
    Ahmedabad Janduring the survived
    calendar month of (group B).
    uary and February
    2012 • Chi-square (χ2)
    test
    • P-Value < 0.05.

    5
    RESULTS

    6
    Distribution of patients according to
    Etiologies

    7
    Factors Affecting Mortality

    8
    DISCUSSION

    9
    • purulent/faecal contamination leads to
    varying degree of septicaemia.
    • The perforations of proximal gastrointestinal
    tract were significantly more common
    contrasting to studies from developed
    countries which revealed that distal
    gastrointestinal tract perforations were more
    common

    10
    • Proximal bowel perforation is mainly on the
    decrease in the developed nations because of
    adoption of therapies against Helicobacter
    pylori.
    • Also better availability of proton pump leads
    to better ulcer relief and healing leading to
    decreased progression of peptic ulcer disease.

    11
    • Etiology and site of perforation also affects the
    outcome.
    • Gastro duodenalperforation occurring mainly due to
    peptic perforation is most common cause which
    accounts for major mortality in developing nations .
    • Post-operative occurrence of abdominal abscesses and
    pneumonia is common which contributes to morbidity
    and then mortality.
    • Also the higher output of proximal GI tract as
    compared to lower GI tract may be another reason for
    the higher mortality

    12
    • Age is important predictor of outcome; with
    extremes of age groups the body tolerance to
    insult caused by peritonitis is reduced which
    shows in the study as there is significantly high
    mortality in those age groups.
    • Physiological limitations of human body
    increase with age in terms of cardiovascular
    respiratory and renal systems.

    13
    • Hypotension and tachycardia also indicate
    poor prognosis as the perfusion to the tissues
    is reduced.
    • preoperative aggressive management of these
    patients in the emergency unit decreases the
    ASA grade of the patient and is associated
    with better outcomes

    14
    • Septicaemia (TC<4000/dL or TC >12000/dL)
    indicates that insult of peritonitis has made the
    general state as hyper catabolic state thus
    significantly reducing the survival rate.
    • the majority of our patients came late to the
    hospital and succumb to death
    • Either they ignored the earlier symptoms, or had
    taken medicinal care for local health facility, or
    were located in places far from centres with
    surgical facilities

    15
    CONCLUSION

    16
    • Peritonitis is one of the commonest emergencies in surgical
    department

    • Delayed presentation significantly adds to the mortality

    • An aggressive preoperative evaluation and steps to correct


    deranged homeostasis, an early surgery and vigilant
    postoperative care are the keys to avoiding postoperative
    mortality in such patients

    17
    THANK YOU

    18

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