Background: Acute peritonitis is one of the most common surgical emergencies we encountered in day today practise. Though the diagnosis of peritonitis is easy but finding thhe underline cause is the diagnostic challenge to every surgeons. This requires a thorough clinical evaluation and specific investigations to have an accurate diagnosis. The management of acute peritonitis is a surgical challenge with high morbidity and mortality. Therefore it is necessary to study and evaluate various factors to understand the underlying cause to reduce the morbidity and mortality.
AIM: Analysis of various causes of acute peritonitis with respect to morbidity and mortality and to assess Mannheim peritonitis index scoring system as a predictor of prognosis in acute peritonitis.
Materials and Methods: It is a prospective study of patients above 18 years of age, who presented with acute peritonitis during the period of August 2020 to Jan 2021 were admitted under the dept of general surgery in Sree mookambika institute of medical sciences, kulashekaram.
Results: Out of 52 patients included in this study, each patients were evaluated seperately and each one is subjected to mannheim peritonitis index score. With the help of scoring system, outcome of the patients were predicted earlier and managed accordingly. In my study population, age group between 41-50 is found to be on higher side with 18 patients (34%) followed by 51-60 years with 15 patients (28.84%). Male gender is more predominant in this study group with 36 patients (69.23%) where female gender on lower scale with 16 patients (30.76%). On assessing the date of persentation, 27 patients of the study population presented to our emergency department with in the first day with 51.9%. Each patients were subjected to earlier investigation and cause of the peritonitis were identified, among the causes of peritonitis, acute intestinal obstruction were found be on higher side in study population with 14 patients (26.92 %) followed by appendicular perforation with 11 patients( 21.15%). 20 patients (38.46%) were presented with signs of shock where remaining 32 patients(61.51%) show no sign of shock. In this study group, patients with Mannheim peritonitis index score less than 26 were noted in 36 patients (69.23%) and score more than 26 in 16 patients (31.73%). During my study, mortality was noted in only one patients with 1.9%.
Conclusion: Mannheim peritonitis index score is found to be a useful stool in assessing the morbidity pre operatively. Patients with score less than 26 were found to have better prognosis with less hospital stay as well as post-operative complications while comparing the patients with score more than 26 were confirmed during my study. Score more than 26 were found to have lot of complications like burst abdomen, wound infection, prolonged hospital stay with significant mortality and morbidity.