PATTERN AND MANAGEMENT OUTCOME OF GENERALIZED PERITONITIS AT HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, EASTERN ETHIOPIA

Abstract

Background: Generalized peritonitis is a microbial contamination of the peritoneal cavity that requires prompt diagnosis and treatment. Despite enhanced comprehension of its pathophysiology, advancements in diagnosis, surgery, antimicrobial therapy, and intensive care aid, peritonitis still has the potential to be lethal. Especially in Hiwot fana Hospital, our patients arrive to Hospital lately that make the management difficult. And there is no data regarding management outcome and clinical pattern of the problem in this Hospital. Objective: The aim of this study is to identify pattern and management outcome of generalized peritonitis among the adult admitted patients at Hiwot fana comprehensive specialized Hospital from Dec 1,2018 – June 1,2023. The data gathered from October 16,2023 to November 1, 2023. Methods: The study was conducted among 650 surgically treated generalized peritonitis patients using cross-Sectional study design by reviewing all patient charts who underwent surgical intervention for the surgically treated generalized peritonitis in the study period. Structured checklist was used to collect relevant data and analyzed using Statistical Package for the Social Sciences version 26 software package. Bi-variate and multi-variate logistic regression was employed to assess association between dependent and independent variables with 95% Confidence interval and p-value less than 0.05. Results: A total of 650 files were used. The mean age was 33.7 years (SD±13.6). And 539 (82.9 %) of them were found to be in the age group of <50 years and the male to female ratio was 5.99:1. Perforated PUD was the predominant intraoperative finding (34.6%) followed by Perforated appendix (31.1%) , Gangrenous SBO (25.8%) and Lower GI perforation (8.5%). Omental patch was the common procedure done (34%). Favorable outcome was found in 72.5% of the cases. Pneumonia (8.6%) was the most common complication. Patients who were < 50 years had 4.6 times more likely to get favorable outcome when compared to those with >=50 years old patients [(AOR- 4.675(1.219-17.933) P-.025)]. Conclusion and Recommendation: Most common pattern is perforated PUD. Older Age, failure to pass and dehydration, lower GI perforation and Hospital stay between 8-15days are associated with unfavorable outcome. Community awareness about generalized peritonitis should increase to avoid late presentation.