Department of General Surgery, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan.
World J Emerg Surg. 2008 Nov 8;3:31. doi: 10.1186/1749-7922-3-31.
Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK) Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome.
A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK) Pakistan, from 1st September 2005 - 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled.
The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6%) and gastric ulcer 1.3%. followed by small bowel tuberculosis (21%) and typhoid (17%). large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%). Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%).
The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular. Malignant perforations are least common in our setup.
穿孔性腹膜炎是全世界以及巴基斯坦外科医生最常见的紧急情况。热带国家穿孔性腹膜炎的病因谱仍与其西方对应物不同。本研究在巴基斯坦的道大学健康科学和卡拉奇民用医院（DUHS 和 CHK）进行，旨在突出东非穿孔性腹膜炎的范围，并改善其结果。
一项前瞻性研究包括 300 例连续穿孔性腹膜炎患者，在临床表现、病因、穿孔部位、手术治疗、术后并发症和死亡率等方面进行研究，在巴基斯坦的道大学健康科学和卡拉奇民用医院（DUHS 和 CHK）进行，时间为 2005 年 9 月 1 日至 2008 年 3 月 1 日，为期两年半。所有患者均进行复苏并接受紧急剖腹探查术。剖腹探查时发现并控制穿孔性腹膜炎的病因。
在我们的系列研究中，穿孔性腹膜炎最常见的原因是胃酸性消化性疾病 45%，穿孔性十二指肠溃疡（43.6%）和胃溃疡 1.3%。其次是小肠结核病（21%）和伤寒（17%）。由于结核病、恶性肿瘤和肠扭转引起的大肠穿孔分别为 5%、2.6%和 0.3%。由于急性阑尾炎引起的穿孔（5%）。穿孔最多见于十二指肠 43.6%，空肠 37.6%，结肠 8%，阑尾 5%，空肠 3.3%，胃 2.3%。总死亡率为（10.6%）。
巴基斯坦穿孔性腹膜炎的范围不断与西方国家不同。与西方国家相比，上消化道穿孔的数量最多，而西方国家的穿孔主要发生在远端。穿孔性腹膜炎最常见的病因是穿孔性十二指肠溃疡，其次是小肠结核病和伤寒穿孔。大多数大肠穿孔也是结核性的。恶性穿孔在我们的设置中最少见。
