CLINICOPATHOLOGICAL STUDY OF SMALL BOWEL PERFORATIONS IN NORTH COASTAL ANDHRA

Abstract

Ÿ Small bowel perforations are one of the most common abdominal surgical emergency . The aim of the study is to review and study patients who have small bowel perforation. To analyze the clinicopathological relations of small bowel perforation in north coastal andhra to understand various causes in geographic variations. This study is a prospective clinicopathological study. 60 patients presenting with features of small bowel perforation were studied. A detailed history was noted in all the patients. Patients underwent both routine and radiological investigations. For pathological analysis, biopsy was taken from the perforation were sent. Co-relation was made between pathological reports and clinical presentation of patients. Ÿ Most patients were males in the age group of 31-40 years. Perforation of the duodenum was most commonly found in all the cases studied. Abdominal pain and distension was found. Guarding and rigidity were present in 70% of cases . On histopathological examination, duodenal perforation was most commonly due to chronic inammation. Ÿ Small bowel perforation commonly presents in middle-aged male working as laborers. Commonly presents with abdominal pain , vomiting, abdominal distension, fever, and constipation are chief complaints. pallor, dehydration, and features of shock were evident. Tenderness, abdominal guarding and rigidity, absent/sluggish bowel sounds were usually found on examination. Air under the diaphragm on erect x-ray abdomen was diagnostic. The pathological analysis was done Chronic inammation was the most common non-traumatic cause of duodenal perforation and nonspecic inammation in ileal perforation found on HPE. Early resuscitation and exploratory laparotomy is the treatment.