All FG-4592 cost patients received 2-3 l of Ringer’s lactate and third generation cephalosporins (ceftriaxone) and quinolones (moxifloxacin), the later given in the last one year of study. With the confirmation of the initial diagnosis of intestinal perforation, emergency laparotomy was performed in all 311 patients. Perforations in the gastrointestinal tract were treated either with primary double-layered closure, segmental resection and anastomosis or loop ileostomy, depending upon the operative findings and general status of the patients. Peritoneal fluid was

sent click here for culture and sensitivity in all patients. The peritoneal cavity was irrigated with an average of 2 l of warm normal saline and drains were left in abdomen and wound was closed either as mass closure or in layers depending upon the operator’s choice. Patients were monitored post-operatively

for recovery and early detection and management of complications. Alvarado scoring was routinely done in our series in patients suspected to have peritonitis secondary to perforated appendicitis. The study was given an approval by the institutional Small molecule library research buy Ethical Review Committee (ERC). Results Three hundred and eleven patients with diagnosis of acute abdomen were included in this study. There were 239 (77%) males and 72 (23%) females. The age ranged from 18 to 75 years with the maximum incidence (89%) in the third decade. Presenting symptoms included abdominal pain (97%), abdominal distension (91%), absolute constipation (80%) and vomiting (58%). All patients (100%) presented with dehydration and shock. Abdominal tenderness and rigidity were present 85 and 83% of the patients respectively. Various investigative findings are depicted in Table 1. Table 1 Abnormalities on the initial investigations Investigations

Janus kinase (JAK) n = 311 Hyponatraemia(Na < 130 mEq/L) 173 (56%) Hypokalemia(K < 2.7 mEq/L) 139 (45%) Blood Urea Nitrogen(> 167 mg/dl) 104 (33%) Serum Creatinine(< 1.7 mg/dl) 82 (26%) Pneumoperitoneum on Chest X-Ray 164 (53%) Air fluid levels on abdominal X-Ray 90 (29%) All 311 patients underwent emergency laparotomy. In 182 (58%) cases, ileal perforation was the underlying cause for peritonitis. The second most common site of perforation was gastroduodenum, found in 56 (18%) patients. Other sites of perforation are shown in Table 2. The aetiology of perforations in 311 patients is depicted in Table 3. Table 2 Site of perforation Site of perforation n = 311 Gastroduodenal 56 (18%)    - Duodenal 37 (11.9%)    - Gastic 19 (6.1%) Jejunal 07 (2%) Ileal 182 (59%) Appendicular 47 (15%) Colonic 19 (6%) Table 3 Aetiology of perforation Aetiology (n = 311) Typhoid 134 (43%) Acid peptic disease 56 (18%) Appendicular 47 (15%) Tuberculosis 43 (13.8%) Trauma 20 (6.4%) Malignancy Ileocaecal Large bowel 11 (3.53%) 02 (0.64%) 09 (2.9%) Two hundred and three (65%) cases were found to have generalized peritonitis while the remaining (35%) had localized peritonitis.