Publication:

Different modes of treatment and complications associated with non-traumatic gastrointestinal perforation

Background Gastrointestinal (GI) Perforation is an important emergency situation that usually requires prompt surgery. Prompt detection of Gastrointestinal (GI) tract perforation is important for the diagnosis of life-threatening conditions in patients with acute abdomen. A number of causes can lead to Gastrointestinal tract perforations (blunt or penetrating trauma, peptic ulcer, inflammatory disease, foreign body, a neoplasm or iatrogenic factors); and has variable clinical presentations, particularly in the early clinical course. Present study aimed at investigating the different modes of treatment and complications associated with non-traumatic gastrointestinal perforation.

Methods This cross-sectional observational study was carried out on patients of Department of general surgery at Late Lakhiram Agrawal Memorial Government Medical college (LAMGMC) Raigarh, Chhattisgarh, India from September 2014 to August 2016. A total 100 adult subjects (both male and females) of all age groups were included in this study.

Results Operative management (44%), conservative management 38% and 18% of cases were managed with Peritoneal drainage under local anaesthesia (LA). Most common complications of peptic perforation cases were toxaemia (32.3%), wound gaping (17.9%) and respiratory complications (11%). Most common complications of typhoid perforation cases were toxaemia (50%), respiratory complications (32.4%), wound infection (22.2%) and wound gaping (18.5%). Most common complications of Appendicular perforation cases were wound gaping (50%) and toxaemia (40%). The average duration of stay in hospital was 16.52 days.  The average duration of stay in hospital of Peptic perforation was 17.3 days, typhoid perforation 18.3 days, Appendicular perforation 18.5 days and for other perforation was 12 days.

Conclusions Majority of the cases undergone for operative management and most frequently developed complications were toxaemia followed by wound gaping and respiratory complications. The average duration of stay in hospital was nearly same for all cases and the stay was less in patients who were managed conservatively.