Study to determine etiological factors and surgical outcome of non traumatic abdominal hollow viscus perforation
DOI:
https://doi.org/10.18203/2349-2902.isj20205369Keywords:
Hollow viscus perforation, Peritonitis, Morbidity, MortalityAbstract
Background: Hollow viscus perforation leading to peritonitis is a common emergency faced by a general surgeon. Late presentation, missed diagnosis and late interventions are frequent causes of morbidity and mortality. Thus in an interest to find out etiological factors, to assess the common type of perforations with their clinical presentation, surgical out come and finally prognosis and complications; forms the basis of present study.
Methods: We carried out prospective study on total of 60 patients presenting with sudden onset pain in abdomen with guarding and rigidity per abdominally for etiology, surgical management and post- operative complications. Study was conducted between 1 January 2018 to 31 December 2018 (12 months), with follow up period up to 30 June 2019 (6 months).
Results: Most common age group involved is 20-39 years (51.6%). Peptic ulcer perforation is the most common cause of hollow viscus perforation (46.4%). Abdominal pain and vomiting were the most common chief complaints and tenderness with guarding rigidity being the most commonly observed sign. Gas under diaphragm on X-ray standing abdomen is suggestive of hollow viscus perforation (41 out of 60 cases) but, it is not obligatory. Surgery is the main modality of treatment. Wound infection is the most commonly observed post-operative complication.
Conclusions: Hollow viscus perforation leading to peritonitis is one of the most common emergencies faced by a general surgeon. Early presentation, Proper diagnosis and timely interventions decrease morbidity and mortality.
References
Langell JT, Mulvihill SJ. Gastrointestinal perforation and acute abdomen. Med Clin Am. 2008;92:599-625.
Dhika V, Singhal S, Pande S, Chawla A, Anand KS. Non-Steroidal drug induced gastrointestinal toxicity: mechanism and management. JIACM. 2003;4:315-22.
Inderbir S. Oesophagus, stomach and intestine, textbook of human histology. 2nd ed. New Delhi; Jaypee Brothers Medical Publisher; 1994:212-25.
Janikalpesh A, Saxena AK. Management of large sized duodenal ulcer perforation by omental plugging, a new technique, a prospective study of 100 patients. Ind J Surg. 2000;62(2):134-8.
Jhobta RS, Attri AK, Kaushik R, Sharma R. A spectrum of perforation peritonitis in India- review of 504 consecutive cases. World J Em Surg. 2006;1: 1146-9.
Kellog LC. A treatise on peptic ulcer perforations. Surgery. 1939;6:524-30.
Dhanapal V, Selvam K. Clinical study and management of hollow viscus perforation of abdomen. Int Surg J. 2017;4(5):1773.
Kumar VB, Mathew AS. Clinical study of abdominal hollow visceral perforation, non traumatic. J Evol Med Dent Sci. 2014;3(30):8366-71.
Dinesh HN, Sachin V, Sreekanth, et al. Clinical evaluation and management of peritonitis secondary to hollow viscus perforation. J Evol Med Dent Sci. 2016;5(19):950-3.
Rao M, Samee AA, Khan SM. Hollow viscus perforation: A retro spectrum study. Int J Recent Sci Res. 2015;6(3):3250-4.
