Background: Gastrointestinal tract (GI) Perforations are emergency situations that require early diagnosis and prompt management. These may account for nearly half of admissions in the General Surgical ward, presenting with Acute Abdomen. A rapid diagnosis and early treatment are important and delay leads to increased mortality and morbidity. The treatment is mainly surgical, with conservative management being reserved for hemodynamically unstable patients with co-morbidities. The common causes of Gastrointestinal Tract Perforation are Blunt or Penetrating Trauma, Peptic Ulcer, Inflammatory Disease, Foreign Body, estrogenic or Neoplasms. These may have variable clinical presentations, notably in the early clinical course. The aim of the author is to investigate the modes of treatment and complications, associated with Non-traumatic Upper Gastrointestinal Perforation.
Methods: This Cross-sectional Observational study was carried out
in the Department of General Surgery at Late Lakhiram Agrawal Memorial, Government
Medical College (LAMGMC) Raigarh, Chhattisgarh, India, from September 2014 to
August 2016. A total of 100 adult subjects (both males and females) of all age
groups were included in this study.
Results: Operative management was done in 44 patients (44%), 38
patients (38%) were managed conservatively & 18 (18%) of cases were managed
with Peritoneal drainage under Local Anesthesia (LA). The most common
complication in patients with Peptic perforation was Toxemia in 32.3% of
patients, followed by Wound breakdown in 17.9% and Respiratory complications in
11% of patients. The most common complications in patients with Typhoid
perforation were Toxemia in 50%, Respiratory complications in 32.4% of
patients, Operative site infection in 22.2% and Wound dehiscence in 18.5% of
cases. Similarly, the most common complication in cases with Appendicular
perforation was Wound breakdown in 50% of patients, followed by Toxemia in 40%
of patients. The average duration of stay in hospital was 16.52 days. The
average duration of hospital stay in patients with Peptic perforation was 17.3
days, for Typhoid perforation 18.3 days, for Appendicular perforation 18.5 days
and for other perforation was 12 days.
Conclusions: Gastrointestinal (GI) Perforation is an important
emergency situation that usually requires prompt surgery often delay in
diagnosis and treatment leads to severe complications and increase morbidity
and mortality. The majority of the cases underwent Operative management and the
most frequent complication encountered was Toxemia followed by Wound Breakdown
and Respiratory Complications. The average duration of stay in the hospital was
nearly the same for all cases but the stay was less in patients who were
managed conservatively.
Author
(s) Details
Shobhita. K. Mane
Department of General Surgery, LAMGM College, Raigarh, Chhattisgarh, India.
Anil Kushwaha
Department of General Surgery, LAMGM College, Raigarh, Chhattisgarh, India.
Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v4/4182
No comments:
Post a Comment