‘’ to Study the Perforation Peritonitis Cases, Diagnosis and Management’’.

Introduction- Peptic ulcer perforation is a serious complication which affects 2-10% of peptic ulcer patients. Peptic ulcer perforation presents with an overall mortality of 10% although various authors had reported incidence between 1.3% and 20%. Being a life-threatening complication of peptic ulcer disease, it needs special attention with prompt resuscitation and appropriate surgical management if morbidity and mortality are to be contained. Aim- was comparative study of Graham's omentopexy versus modified Graham's omentopexy in duodenal perforation. Methods and materials- This prospective, single centre study done in NSCB Medical college jabalpur Madhya Pradesh from 2020 to 2022 for two years of periods. Total 180 patients studied Results- There are duodenal perforation is most common found in 88.88% and then ileal perforation is 6.66%. other perforation like gastric, duodenal, jejunal, appendicular, colonic, rectal perforation also found. Most of the patients fall between 20-78 years of age in both A and B groups. The maximum number of patients were 72(40%) found in the age group of 40-50 years. There is 156 male and 24 females are present the study. Post operative leakage was 7.5% and 1.25% respectively. There was 6.25% burst abdomen in group A and 1.25% in group B cases. 100 patients (67%) had perforation within range 0.5-1 cm in size. The postoperative complications in group A were wound infection 10[12.5%], bile leakage 6 [7.5%], respiratory complications 8 [10%], electrolyte imbalance 12 [15%], paralytic ileus 3 [3.75%], septic shock 5 [6.25%] and abdominal abscess in 5 [6.25%] and in group B were wound infection 6[7.5%], bile leakage 1 [1.25%], respiratory complications 3 [3.75%], electrolyte imbalance 5 [6.25%], paralytic ileus 2 [2.5%], septic shock 2 [2.5%] and abdominal abscess in 2 [3.75%]. Mortality rate in Group A (3.75%) and in Group B (1.25%). The overall mortality rate was 7.14%. In this study average hospital stay was 12.4 days in group A and 9.0 days in group B. conclusion- This study showed that modified Graham's patch repair is as effective as Graham's patch repair in terms of mean operative time period, timing of oral feed allow and mean hospital stay timing.