Background: Perforation peritonitis is a critical abdominal emergency requiring urgent surgical intervention and is associated with significant morbidity and mortality. The clinical spectrum varies according to etiology, site of perforation, and timing of presentation. This study aimed to evaluate the demographic characteristics, clinical profile, operative management, postoperative complications, and outcomes in patients with hollow viscus perforation. Material and Methods: This prospective observational study included 50 patients with clinically and/or radiologically confirmed perforation peritonitis at a tertiary care teaching hospital. Patients older than 12 years were included, while traumatic, primary, and postoperative peritonitis cases were excluded. All patients underwent emergency exploratory laparotomy. Data regarding demographic profile, clinical presentation, radiological findings, intraoperative site of perforation, operative procedure performed, postoperative complications, and outcomes were systematically recorded and analyzed. Results: The majority of patients were aged ≥50 years (34%), with a male predominance (74%). Delayed presentation beyond 3 days was observed in 42% of cases. Generalized tenderness was present in 58%, and pneumoperitoneum was detected radiographically in 78% of patients. Peptic perforations (34%) were most common, followed by ileal (28%) and appendicular (18%) perforations. Modified Graham’s omentopexy was performed in 34% of cases, while primary repair (24%), appendicectomy (18%), resection and anastomosis (16%), and resection with diversion stoma (8%) were undertaken based on intraoperative findings. Surgical site infection (26%) was the most frequent complication. The mortality rate was 16%, and 76% of patients were discharged after recovery. Conclusion: Perforation peritonitis predominantly affects elderly males and is frequently associated with delayed presentation. Early diagnosis and prompt surgical intervention are essential to reduce complications and mortality.

Perforation peritonitis; Hollow viscus perforation; Emergency laparotomy; Surgical site infection; Mortality