H. Noorul Ayesha, Alex Arthur Edwards, 
    Surgical Management of Peritonitis Secondary to Hollow Viscus Perforation a Prospective Observational Study,
    Research Journal of Medical Sciences,
    Volume 19,Issue 4,
    2025,
    Pages 126-128,
    ISSN 1815-9346,
    makrjms.2025.4.126.128,
    (https://makhillpublications.co/view-article.php?doi=makrjms.2025.4.126.128)
    Abstract: Peritonitis requires emergency surgical intervention and is associated
with significant morbidity and mortality rates. The presence of pneumo
bperitoneum on radiographs is confirmatory of viscus perforation. The
definitive diagnosis should be arrived at the shortest period of time with
available investigations. Cases of peritonitis secondary to hollow viscus
perforation undergoing emergency laparotomy was assessed for the site
of perforation, its pathological condition and the amount of peritoneal
contamination. Depending on the site of perforation and pathological
condition, appropriate procedure will be adopted for its management,
that includes omental patch closure, simple closure, open appendectomy,
resection anastomosis and loop ileostomy. Postoperatively patients was
examined for the development of any complications. The procedure
performed intraoperatively depended upon the operating surgeon and
the site of perforation noted in situ. Study duration was between June
2022 to September 2023 , 50 patients who were older than 18 years with
primary unilateral uncomplicated inguinal hernia, who presented for
operation in the department of General surgery, Sree mookambika
college of medical sciences Kulasekharam were considered eligible for the
study. Each patient presenting with peritonitis was examine thoroughly
after taking a detailed history. The diagnosis was confirmed by history,
clinical features and erect abdominal X-ray. Cases of peritonitis secondary
to hollow VISCUS perforation undergoing emergency laparotomy was
assessed for the site of perforation, its pathological condition and the
amount of peritoneal contamination. Whenever there was a suspicion of
peritonitis or the radiograph was inconclusive, it was proceeded with
computed tomography. It was done in 35% of the cases and the findings
included the presence of free fluid in 27% cases, free air in 19% cases, fat
stranding in 14% cases and air pockets in 5% cases. Free air was noted in
16% cases of duodenal perforation because the radiograph was
inconclusive in these cases. All the cases diagnosed with fat stranding had
appendicular perforation intraoperatively. All the cases of perforation
were initially stabilized and proceeded with laparotomy, since most of the
cases had duodenal perforation, omental patch repair was done in all
these cases.
    Keywords: Ileal perforations; omental patch; peritonitis