Abstract

 
Introduction: Acute gastrointestinal perforation is one of the most serious and frequently encountered surgical emergencies with high morbidity and mortality. The study was conducted to assess various indicators like age, sex, duration, site, number of perforations, cause, type of surgery, associated comorbidities and postoperative complications which influence morbidity and mortality.
Methods: This study was a prospective observational longitudinal study conducted from September 2016 to august 2018.Total 96 cases were included in the study excluding below 20 years and above 80 years of age group.
Results: The site of perforation was duodenum (31.3%), Ileum (28.1%), stomach (15.6%), appendix (8.3%), caecum (6.3%), sigmoid colon (6.3%) and jejunum (4.2%). Main causes include Gastro duodenal ulcer (39.5%), malignancy (15.7%), typhoid (14.6%), trauma (10.4%) and ileo-caecal tuberculosis (7.3%). Simple closure with drainage mortality rate (12.7%), right hemi colectomy(53.8%) and Hartmann’s procedure(50%).Surgical site infection is the most common post-operative complication(29.2%) followed by post- operatve pneumonia (14.6%) and renal failure(13.5%). Overall morbidity rate was 58.3% and mortality rate was 18.8%.
Conclusion: The most common site of acute gastrointestinal perforation is duodenum followed by ileum. High mortality is observed in cases presenting late due to overwhelming sepsis. Surgical site infection is associated with high morbidity whereas anastomotic leak associated with high mortality. Therefore, early diagnosis and timely surgical intervention with adequate antibiotic prophylaxis and effective management of post-operative complications can reduce the incidence of morbidity and mortality.