Outcome of surgeries for non-traumatic hollow viscous perforations

Abstract

Background: Patients with non-traumatic hollow viscous perforations present challenge to the surgeons and outcome depends upon location and surgeon skills. Present study was to investigate the outcome of surgeries for non-traumatic hollow viscous perforations.Methods: This is a prospective observational study carried out in surgical wards in Mamata General Hospital between October 2015 and September 2017 over a period of 02 years. Evaluation of all the patients fulfilling the inclusion and exclusion criteria with respect to history, physical findings, operative findings and postoperative complications in line with the predetermined objectives was done. Various treatment modalities available and their outcome were also evaluated.Results: Benign causes of gastrointestinal perforation constituted majority of non-traumatic gastrointestinal perforations. Peptic ulcer perforation (68%) was the major cause of gastrointestinal perforation. Most common site for non-traumatic gastrointestinal perforations was duodenum (48%). Simple closure with omental patch was the operative procedure done for all cases of peptic ulcer perforation and appendicectomy for appendicular perforation. Ileal perforations secondary to typhoid perforation were treated with resection and end-to-end anastomoses in the present study. Colonic perforation was managed with Hartmann’s procedure. Most common complication was SSI (34%). Mortality was 8% and was due to septicemia.Conclusions: Aggressive resuscitation and early meticulous surgery is required to decrease morbidity and mortality in hollow viscous perforation cases.