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

Abstract

[Accepted Research Article]

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

Methods: A prospective observational study was conducted at the Department of Surgery of the University Teaching Hospitals (UTH), Lusaka from July 2018 to March 2019. All consecutively admitted patients aged 18 years and above undergoing emergency exploratory laparotomy for non-traumatic perforation peritonitis were included in the study.

Results: One hundred patients participated in the study (77 males, 23 females), and the mean age was 37.24 (range 18 to 78 years). The main site of perforation was stomach in 49 (49%), small bowel in 40 (40%), colon in 8 (8%), both small bowel and colon in 1 (1%), urinary bladder 1 (1%), and unidentified site in 1 (1%). The postoperative outcomes included leak 9%, wound dehiscence 3%, and re-laparotomy 17%. The frequency of outcome (leak, relaparotomy and mortality) were highest for stomach followed by ileum. The stomach was significantly related to the outcome of leak (p=0.008). The mortality rate was 36%.

Conclusions: The stomach was the leading site of perforation. The commonest postoperative outcome was re-laparotomy. Perforation peritonitis has a high mortality rate.