After resuscitation all patients under general anaesthesia were subjected

to exploratory laparotomy. Adequate hydration was indicated by an hourly urine output of 30 ml/hour. An initial systolic 17DMAG research buy blood pressure (SBP) on each patient was also recorded on admission. Preoperative shock was defined as a preoperative systolic blood pressure of less than 90 mmHg. Table 1 American Society of Anesthetists (ASA) classification ASA class Description I Healthy individual with no systemic disease II Mild systemic disease not limiting activity III Severe systemic disease that limits activity but is not incapacitating IV Incapacitating systemic disease which is constantly life threatening V Moribund, not expected to survive 24 hours with or without operation Note: E is added to the class when the case is an emergency e.g. IIE refers

to ASA class scheduled for emergency surgery Laparotomy was performed by a midline incision; all dirty yellow purulent material was aspirated from peritoneal cavity. General survey of peritoneal cavity was made. In patients with single perforation, the edge of the intestinal perforation was excised, and double-layer closure was done with chromic catgut or coated vicryl 2/0 and silk 2/0. Patients with multiple perforations had bowel resection and anastomosis. Ileostomy and damage control surgery was done in patients with ASA class VE. Copious peritoneal lavage was done with warm isotonic saline, 2 drains were placed, one in the pelvis, the other

in the right paracolic gutter, and mass closure of the abdomen was done using nylon-1. The skin was Carnitine palmitoyltransferase II closed with interrupted stitches of nylon-2/0. Post-operatively patients SCH772984 purchase were kept nil orally till return of bowl sounds and at that time nasogastric tubes were removed. IV antibiotics were used for one week. Drains were removed on 6th post operative day. The postoperative outcome was monitored; patients in ASA classes IV and V were admitted into intensive care unit after surgery. Data on each patient were entered into a pro forma prepared for the study. The study variables included socio-demographic data (i.e. age and sex, level of education, occupation and area of residence), clinical presentation, HIV status, radiological findings, perforation-surgery interval, ASA classification, operative findings (such as type of peritonitis, degree of contamination and number of perforations), antibiotics used and surgical procedure performed. The variables studied in the post-operative period were postoperative complications, hospital stay and mortality. Statistical analysis The statistical analysis was performed using statistical package for social sciences (SPSS) version 15.0 for Windows (SPSS, Chicago IL, U.S.A).The mean ± standard deviation (SD), median and ranges were calculated for continuous variables whereas proportions and frequency tables were used to Selleckchem ABT263 summarize categorical variables. Continuous variables were categorized.