Epidemiological study of peritonitis in pediatric population and factors predicting mortality. Case of CHUK.

Abstract

Background: Peritonitis in children is a life threatening surgical condition requiring prompt and adequate surgical management. The knowledge of its common causes and factors linked with its morbidity and mortality may contribute to early recognition of patients in need of special care. Objectives: This study aims at identifying common causes of peritonitis in children and factors affecting morbidity and mortality. Methods: A prospective observational study was done on 63 patients operated for peritonitis from 1st September 2015 to 28th February 2016 at CHUK. Results: Of 63 patents, 35 were male and 28 female, sex ratio (M: F) was 1.25:1. The age ranged from 4 months to 15 years, the mean was 8.8 years. 73% of patients presented within the first week of symptom onset. 14 of 63 died (22.2%); 2 died on table; 6 died of sepsis in ICU settings and 6 of post operative respiratory problems. 4 of 6 patients (66.7%) who had traumatic small bowel perforation died. Appendicular perforation (25.4%) and gangrenous intussusceptions (23.8%) were the common causes of peritonitis. 60.3% were operated after 24 hours of admission. 74.6% of morbidity and 22.2% mortality were registered. The principal operator; symptom duration; post operative ICU admission and septic shock were potential predictors of mortality. (p<0.05) Conclusion: Peritonitis in children is a life threatening surgical emergency at CHUK, bearing a significant morbidity and mortality. A wide variety of factors are linked significantly with the overall outcome. Efforts need to be put in reducing the delayed presentation, improving survival of trauma related peritonitis by providing care providers at different levels with regular training in terms of trauma management and ICU inputs to improve recovery for this particular group of patients.