Prasan Kumar Hota
Patients with non-traumatic hollow viscous perforations present challenge to the surgeons and outcome depends upon location and surgeon skills. Ileal perforation is common surgical emergency in tropical countries due to high incidence of enteric fever and tuberculosis. Present study was to investigate the outcome of surgeries for non-traumatic hollow viscous perforations. This is a prospective observational study carried out in surgical wards in Mamata General Hospital over a period of 04 years. Evaluation of all the patients fulfilling the inclusion and exclusion criteria with respect to history, physical and investive findings, operative findings and postoperativecomplications in line with the predetermined objectives was done. Various treatment modalities available and their outcome were also evaluated. Benign causes of gastrointestinal perforation constituted majority of non-traumatic gastrointestinal perforations (99%), whereas only 1% case was due to malignancy. Peptic ulcer perforation (54%) was the major cause of gastrointestinal perforation. Simple closure with omental patch was the operative procedure done for all these cases. Small intestinal perforation was found in 27% cases, which was managed by resection and end to end anastomosis. Appendicectomy was done for appendicular perforation (12%). Colonic perforation was seen in 7% cases, which were managed by resection anastomosis or Hartman’s procedure depending on cases. Most common complication was SSI (34%). 03 cases (2.7%) found to have fungal peritonitis, Mortality was 5.4% and was due to sepsis and septic shock. Aggressive resuscitation and early meticulous surgery is required to decrease morbidity and mortality in hollow viscous perforation cases.
Share this article