AN OBSERVATIONAL STUDY OF CLINICAL PROFILE AND MANAGEMENT OF NON-TRAUMATIC SMALL BOWEL PERFORATION AT TERTIARY CARE CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 32
Abstract
BACKGROUND Perforation peritonitis is a common surgical emergency faced by general surgeon in India. It is associated with significant morbidity and high mortality rate. This work has been carried out to study various aetiology, clinical feature, diagnostic dilemmas and management of non-traumatic small bowel perforation at a tertiary care centre. Traumatic small bowel perforations were not included in the study. MATERIALS AND METHODS This cross-sectional observational study was performed at a tertiary care centre. All patients undergoing exploratory laparotomy for non-traumatic small bowel perforation were included in the study from 1st January 2015 to 30th June 2016. The patient’s demographic data, clinical profile, diagnostic studies, intraoperative findings during laparotomy, surgical interventions performed, postoperative complications and final outcome were recorded and evaluated. RESULTS A total of 80 patients, 21 females and 59 males, between age ranges of 18 years and 90 years underwent exploratory laparotomy for non-traumatic small bowel perforation. Symptoms were abdominal pain, obstipation, abdominal distension, fever and vomiting. The cause of perforation was typhoid in 66 patients followed by ischaemic bowel disease in 6 and tuberculosis in 5 patients, and malignancy, intussusceptions, worm infestation in 1 patient each. 67 patients had ileal perforation, while 13 patients had jejunal perforation. 67 patients had single perforation, while 13 patients had multiple perforations. Various surgical procedures according to intraoperative findings were performed, 90% patients were discharged. CONCLUSION Typhoid fever is the most common cause of non-traumatic small bowel perforation followed by ischaemic bowel disease and tuberculosis in our study. Early surgical intervention under the cover of broad-spectrum antibiotics preceded by aggressive resuscitation and correction of electrolyte imbalance is imperative for good outcomes minimising morbidity and mortality.
Authors and Affiliations
Kiran Somani, Rishikant Vashistha, Sanjay Datey, Abhishek Gurjar, Akhilesh Patel
Keywords
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- EP ID EP541152
- DOI 10.14260/jemds/2018/804
- Views 77
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