Acute Generalized Peritonitis: Surgical Management Options View PDF

Alaa Salman Dawood Alahmed
Department Of Surgery, Al-Sadder Teaching Hospital, Basrah Health Directorate, Ministry Of Health, Basrah, Iraq

Published on: 2024-11-08

Abstract

Background: Acute generalized peritonitis (AGP) is an acute disseminated inflammation of the peritoneum caused by septic inoculation, most often from an intraperitoneal organ, and more rarely after systemic contamination. The aim was to contribute to the management of AGP in Basrah.

Methods: This is a descriptive study in the department of surgery of Al-Sadder Teaching Hospital, Basrah Health Directorate, Ministry of Health at period of 12 months of 2023. All patients received, operated on and followed up in the department for AGP during the study period were included.

Results: Clinical signs included abdominal pain and abdominal contracture in all patients. Peptic ulcer perforation accounted for 41.9% (n = 25) of cases. The mean age of patients was 35.47 years and the age group most affected was 15 - 29 years, i.e., 46.8%. Males were most affected, with 75.8% of cases and a sex ratio of 3.1. The clinical picture was dominated by abdominal pain and abdominal contraction in all patients. Etiologies were dominated by peptic ulcer perforation in 41.9% (n = 25) of cases, followed by appendicular peritonitis in 24.2% (n = 14).

Conclusion: AGP is a frequent abdominal emergency. Management is medical-surgical. Good resuscitation and peritoneal cleansing could improve the management of AGP.

Keywords

Acute generalized peritonitis, Abdominal pain, Stercoral fistula, Perforation, Bulging the Douglass

Introduction

AGP is an acute disseminated inflammation of the peritoneum caused by septic inoculation, most often from an intraperitoneal organ, and more rarely after systemic contamination [1]. They may be primary, secondary or tertiary. Peptic ulcer perforation is the most frequent etiology. Ileal perforations are also found to a lesser extent in series from tropical countries [2]. In sub-Saharan Africa, they pose a real public health problem, due to the morbidity and mortality they entail [3]. Management combines pre-, intra- and postoperative resuscitation, surgical eradication of intraperitoneal infection and appropriate antibiotic therapy [4]. It is a serious medical and surgical emergency. Its severity depends on the patient’s age, general condition, associated defects, etiology and the time required for treatment [5]. The aim of this study was to contribute to the improvement of the management of AGP in Basrah.