Gastrointestinal perforations: a tertiary care center experience

Abstract

Background: In spite of the advances in surgical techniques and antimicrobial molecules, gastrointestinal perforations still remain highly fatal. Delay in diagnosis as well as referral is often attributed to be the cause behind the high mortality caused by this condition. The aim of the study was to elucidate the etiological factors of gastro intestinal perforation as well as postoperative outcome among patients undergoing treatment at a tertiary care centre.Methods: This was a Descriptive study of patients admitted with gastro intestinal perforation in the General Surgical wards of Government Medical College, Trivandrum from March 2014 to February 2015. The demographic, clinical, operative and post-operative findings were entered into a structured performa and analyzed statistically.Results: Atraumatic perforation was found to predominate over traumatic perforations. Most of the atraumatic perforations belong to the age groups between 21 and 30. Also, there is a high male predominance among these patients. Proximal gastrointestinal tract injuries predominate much more than distal ones. Increased morbidity is seen if there are associated co morbidities and risk factors including smoking and alcohol abuse. Mortality rate is highest in traumatic injuries involving colon and rectums.Conclusions: Mortality due to perforation peritonitis is still a challenge to the surgeon and burden to the society. Early diagnosis and treatment will positively alter the outcome of a gastrointestinal perforation and can be ensured only by timely arrival of the patients to hospital and subsequently by early intervention. This in turn depends mostly on strengthening the primary care and referral services.