A group of researchers studied the role of intraperitoneal drainage in the resuscitation of patients with perforation peritonitis during the corona pandemic. It was a retrospective study that enrolled patients of peritonitis with bilateral pulmonary crepitations, SpO2 less than 92%, PaO2 less than 60 mmHg on arterial blood gas (ABG), and chest x-ray (CXR) finding of bilateral infiltrates. 

High suspicion of associated coronavirus infection in such patients demands polymerase chain reaction (PCR) for virus detection and special measures are required for resuscitation before any definitive treatment. So there remains a usual delay of 6-8 hours to ensure proper safety measures and dedicated operation theatres. 

All patients observed initial resuscitation with intravenous fluids and broad-spectrum antibiotics. 27 patients got resuscitation with preoperative intraperitoneal drainage waiting meanwhile for PCR, whereas 13 patients got resuscitation without drainage. 

The results of the study came out as follows-

43.73 ± 16.04 years were the mean age of the patients. 

Perforations due to duodenal ulcer, typhoid, tuberculous (TB), and biliary origin were the frequent cause of peritonitis. 

Coronavirus infection was suspected with the variables- SpO2 < 92%, PaO2 <60mmHg and bilateral infiltrates on chest x-ray. 

9 patients were PCR positive for coronavirus. 

29.6% mortality was observed in those resuscitated with intraperitoneal drainage before the definitive procedure 

54% mortality was observed in those not resuscitated with intraperitoneal drainage. 

Thus Intraperitoneal drainage, when utilized early in the management of perforation peritonitis shows a reduction in morbidity and mortality in suspected corona infected patients.

Source: Cureus. 2021 May 18;13(5):e15083. doi: 10.7759/cureus.15083. PMID: 34155454; PMCID: PMC8209761.