Prospective Study Determine Etiology, Risk Factors of Non-Traumatic Small Intestinal Perforation

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Abstract (English)

Abstract
Aim: The aim of the present study was to assess the etiology and risk factors of non-traumatic small intestinal
perforation.
Material & Methods: This prospective study was conducted in the Department of General Surgery, 50 patients
were included. The patients with intestinal perforations due to trauma, mesenteric ischemia and obstruction or
strangulation because of hernia, volvulus or intra- abdominal adhesions, and peptic ulcer perforations of the
duodenum were excluded from the study.
Results: Patients were of 20-30 years of age followed by 20% who belonged to 10-20 years age group. Mean
age of the patients who presented with perforation peritonitis was 35.5 years that shows age was not a
confounding factor. Among patients who presented with perforation peritonitis, majority (84%) of the patients
were males. Only 9 out of 50 patients were females suggesting gender was not a confounding factor. Out of the
50 cases, 42% were caused by peptic ulcer, 22% by tuberculosis, 18% by typhoid, 10% by ischemic bowel
disease, 2% by malignancy, 4% by intussusception, and 4% by worm infestation. The p-value cannot be
determined from this table alone as it only provides the frequency distribution of the etiology of the disease.
Abdominal tenderness was present in all patients, signs of peritoneal irritation were present in 38 (76%)
patients. The other patients had moderate localized or generalized tenderness but relatively soft abdomen. Out of
the total of 50 cases, 68% underwent primary repair, 12% underwent resection with primary anastomosis, 12%
underwent resection with exteriorization of the bowel, another 6% underwent resection with anastomosis and
proximal stoma, and 2% received palliative drainage.
Conclusion: Non-traumatic small bowel perforation is a serious condition associated with significant morbidity
and mortality. The etiology, clinical presentation, and outcomes can vary depending on geographical location
and patient population. Prompt recognition, appropriate investigations, and early surgical intervention remain
crucial in managing this condition effectively.