CLINICAL SIGNIFICANCE AND CORRELATION OF INTRA-ABDOMINAL PRESSURE WITH THE OUTCOME OF PERFORATION PERITONITIS

Abstract

Background: A progressive increase in intra-abdominal pressure (IAP) may cause abdominal compartment syndrome (ACS) with organ dysfunction.  However, it remains strangely underdiagnosed.

Objective: To correlate Intra-abdominal pressure with the outcome in perforation peritonitis patients.

Methods: An Observational study was done on 50 patients with perforation peritonitis and patients undergoing intervention in the form of either emergency laparotomy or drain placement. The abdominal pressures were indirectly determined by measuring urinary bladder pressure with a Foley's catheter. Pearson correlation was used to see relation between intra- abdominal pressure and outcome of peritonitis. SPSS version 16 (trial) was used for analysis.

Results: Mean intra-abdominal pressure during time of presentation to the hospital was 26.4±3.8cm H₂O. Among various morbidities following operation, surgical site infection was most common (36%) followed by wound dehiscence (30%). There was strong linear correlation between intra-abdominal pressure and factors determining morbidity such as surgical site infection, wound dehiscence, burst abdomen.

Conclusions: There is a strong correlation of various co morbidities with increased intra-abdominal pressure in patients with perforation peritonitis which was significant statistically.

Keywords: Intra- Abdominal Pressure, Intravescical pressure, perforation peritonitis, Abdominal Compartment Syndrome.