Peritonitis due to peptic ulcer perforation: Epidemiological, diagnostic and therapeutic aspects in the general surgery department of the Idrissa POUYE general hospital

Abstract

Introduction: Peritonitis is an acute inflammation of the peritoneal serosa due to the presence in the peritoneal cavity of an aggressive liquid, but not necessarily septic, which may be generalized or localized, primary or secondary often to a perforation of peptic ulcer. The objective of our work is to study the epidemiological, diagnostic and therapeutic aspects of acute generalized peritonitis due to peptic ulcer perforation in the General Surgery Department of the Idrissa POUYE General Hospital. Patients and Method: This was a retrospective and descriptive monocentric study of 72 cases of acute generalized peritonitis due to peptic ulcer perforation from January 1st 2008 to December 31st 2021. Results: The prevalence of peritonitis due to peptic ulcer perforation was 4.3% in surgical emergencies at the Idrissa POUYE general hospital in Dakar. The average age of our patients was 36.3 years with extremes of 16 and 67 years. The clinical signs were mainly abdominal pain (100%), vomiting 75% (N=54), transit arrest 69.44% (N=50). An X-ray of the abdomen without preparation was performed in 79.17% of cases (N=57) with the presence of pneumoperitoneum in 89.4% of cases (N=51). Surgical treatment was performed in 95.83% of patients (N=69). Postoperative complications were observed in 9 patients (13.04%) and operative mortality was 2 patients (2.89%). Conclusion: Peritonitis due to ulcer perforation is a medical-surgical emergency that mainly affects young subjects. The diagnosis is above all clinical, confirmed by the radiography of the abdomen without preparation.