Abstract

The objective of the study was to study the various causes, incidences and clinical features of small bowel perforations and various surgical procedures and it’s the outcome.
Methods: The present study was conducted in the Department of General Surgery for the period of 2 years and all the patients of small bowel perforation of both sexes and of different ages was included. 50 patients were included in the study. The protocol was reviewed and approved by the ethics committees of this institution. Patients were included after taking their informed consent for the study.
Results: In the present study, majority of the patients (36%) were of age group 36-45 followed by (28%) 26-36 age groups. There were 40 (80%) males as compared to females 10 (20%). In this study, 35 cases (70%) of perforation were due to peptic ulcers. Next order cases due to trauma consist of 10 cases (20%). Tubercular perforation was seen in 2 patients (4%), and due to Crohn’s disease, only 1 case was found. Typhoid perforation was seen in 1 case. Malignant perforation was in 1 case (2%) which was found to be gastrointestinal stromal tumours after histopathological examination. In this study, free peritoneal fluid was found in 43 cases (86%). Free gas in the peritoneal cavity was found in 40 cases (80%) due to third space fluid collection and escape of bowel gas into the peritoneum, respectively. Mesenteric lymphadenitis and thickened omentum were found in 2 cases (4%) due to tuberculosis and malignancy.
Conclusion: Duodenal perforation is the most common cause of small intestinal peforation. Smoking and consumption of alcohol & NSAIDS are the most important risk factors for small bowel perforation. Patients mainly presented with abdominal pain and distension with features of peritonitis. X-ray abdomen suggested of pneumoperitoneum in most of the patients. Resuscitation followed by closure of perforation with omental patch was the most common management procedure done.