Early postoperative complications associated with perforation peritonitis at a tertiary teaching hospital in Lusaka, Zambia: A prospective, observational study

Abstract

Background: Perforation peritonitis is a common surgical emergency seen by surgeons and remains a life-threatening condition with high morbidity and mortality. This study aimed to determine the site of perforation and the postoperative complications of perforation peritonitis.

Methods: This prospective, observational study was conducted at the Department of Surgery, University Teaching Hospital in Lusaka, Zambia, from July 2018 through March 2019. All consecutively admitted patients aged ≥18 years undergoing emergency exploratory laparotomy for nontraumatic perforation peritonitis were included in the study.

Results: One hundred patients participated in the study (77 men, 23 women), and the mean age was 37.24 (range, 18-78 years). The main site of perforation was the stomach in 49 patients (49%), the small bowel in 40 (40%), the colon in 8 (8%), both small bowel and colon in 1 (1%), urinary bladder in 1 (1%), and unidentified site in 1 (1%). The postoperative outcomes included anastomotic leakage (9%), wound dehiscence (3%), and relaparotomy (17%). The frequencies of unfavourable outcomes (anastomotic leakage, relaparotomy, and death) were highest in association with stomach perforations, followed by ileal perforations. The stomach was significantly prone to anastomotic leakage (P=0.008). The mortality rate was 36%.

Conclusions: The stomach was the leading site of perforation. The commonest postoperative outcome was relaparotomy. Perforation peritonitis is associated with a high mortality rate.