A prospective study to assess clinical profile and golden period for operative intervention in patients with perforation peritonitis

Background: Perforation peritonitis constitutes one of the most common surgical emergencies encountered by surgeons. Even with modern treatment, diffuse peritonitis carries a high morbidity and mortality rate.Methods: The prospective study was conducted at department of surgery on 50 patients of perforation peritonitis admitted in emergency department of hospital. Detailed history, clinical examination and investigations were carried out. Patients were operated upon and findings were noted. Comparisons were done for postoperative ICU stay, morbidity/ mortality, oral feed and total hospital stay between the patients who reported within 24 hours and after 24 hours of onset of symptoms to determine golden period for operative intervention.Results: Out of total 50 patients, 21(42%) patients presented within 24 hrs of onset of first symptom of perforation while 29(58%) patients presented after 24 hours. Postoperative ICU stay, morbidity/ mortality, delay in oral feed and total hospital stay was statistically more in patients presenting after 24 hours.Conclusions: It can be concluded that the golden period of 24 hrs between the onset of symptom and start of treatment is the most important factor to determine the outcome.