Causes, Frequency and Risk Factors of Burst Abdomen in Patients With Peritonitis

Kainat Zafar, Tunza Irfan, Mazhar Iqbal, Khadija A.Rehman, Shahneela Manzoor, Saba Patoli

Abstract

Objective: To find out the causes, frequency and risk factors of burst abdomen in patients presenting with peritonitis.

Study design: Cross sectional observational study

Place and duration of study: Surgical ward 2, Jinnah Postgraduate Medical Center (JPMC) Karachi, from September 2021 to September 2022.

Methodology: All the patients with peritonitis who presented through emergency department were included. Risk factors like anemia, diabetes mellitus, hypertension, obesity, respiratory infection, frequency of burst abdomen and causes like typhoid ileal perforation, tuberculous perforation, ruptured appendix, duodenal ulcer perforation, ruptured liver abscess were recorded on pre designed forms. 

Result: The age of the 90 patients who presented with acute peritonitis was from 13 years to 65 years with the mean age of 39±5 year. There were 60 (66.67%) male and 30 (33.33%) female patients. Burst abdomen occurred in 24 (26.66%) patients. Causes of peritonitis were ruptured liver abscess (n=4 - 4.44%), colonic perforation (n=2 - 2.22%), intestinal tuberculous ileal perforation (n=9 - 10%), duodenal ulcer perforation (n=19 - 21.11%), ruptured appendix (n=17 - 18.89%) and typhoid ileal perforation (n=38 - 43.33%). The risk factors in burst abdomen were hypoalbuminemia (66.67%), postoperative respiratory tract infection/cough (41.67%), intra-abdominal collection (33.33%), anemia (8.3%), paralytic ileus (16.67%), obesity/BMI>30 (8.3%). A total of 66 (73.33%) patients recovered uneventfully.

Conclusion: The most common cause of peritonitis was typhoid ileal perforation and frequency of burst abdomen was 26.66% in this group of patients.

Key words: Burst abdomen, Peritonitis, Risk factors, Enteric perforation, Tuberculous ileal perforation.