Generalized peritonitis in India--the tropical spectrum.

L Sharma, S Gupta, A S Soin, S Sikora, V Kapoor
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引用次数: 96

Abstract

Generalized peritonitis is a common surgical emergency in India, the 'Tropical Spectrum' of generalized peritonitis being different from the western spectrum. A total 155 cases of generalized peritonitis were surgically treated at the All India Institute of Medical Sciences between 1981 and 1987, all patients undergoing peritoneal toilet with drainage after the cause of their peritonitis had been treated. The most common cause of peritonitis was peptic ulcer perforation, with simple closure being associated with a 2 per cent mortality, while typhoid perforation was the second most common cause. The diagnosis was clinical, supported by the operative findings of a terminal ileal perforation while bacteriological, serological and histopathological confirmation was retrospective. Appendicular perforations were less common than in the west but the clinical picture was the same. Tubercular perforations were not uncommon with a previous history of subacute intestinal obstruction and evidence of tuberculosis on chest X-ray suggesting the diagnosis. Ruptured amebic liver abscess was the most common hepatobiliary cause of generalized peritonitis with drainage of the abscess producing good results. The average hospital stay was 15 days with an overall mortality of 8 per cent.

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印度的广泛性腹膜炎——热带地区。
在印度,广泛性腹膜炎是一种常见的外科急诊,广泛性腹膜炎的“热带谱”与西方谱不同。1981年至1987年期间,全印度医学科学研究所共手术治疗了155例广泛性腹膜炎,所有患者在治疗了腹膜炎的病因后都进行了腹膜厕所引流术。腹膜炎最常见的原因是消化性溃疡穿孔,简单的闭合与2%的死亡率有关,而伤寒穿孔是第二常见的原因。该诊断是临床的,支持手术发现的终末回肠穿孔,而细菌学,血清学和组织病理学确认是回顾性的。阑尾穿孔较西方少见,但临床表现相同。结核性穿孔并不罕见,既往有亚急性肠梗阻病史,胸片上有结核的证据,提示诊断。阿米巴肝脓肿破裂是全身性腹膜炎最常见的肝胆原因,脓肿引流效果良好。平均住院时间为15天,总死亡率为8%。
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