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Volume 2024, Issue 4
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Hollow viscus perforation is one of Pakistan’s most commonly encountered surgical emergencies. Gastroduodenal perforations account for the most common site of perforations worldwide. However, the Pakistani population has a different pattern.

The aim of this study was to determine the clinico-pathologic features of patients and the effectiveness of surgical options in the emergency management of bowel perforation.

This retrospective, observational study was conducted at the Department of General Surgery, Unit-III, Lahore General Hospital, Lahore from January 1, 2021 to December 31, 2021. Data on demographic profiles, clinical presentation, risk factors, site of perforation, and surgical details of 73 patients with gastrointestinal perforation admitted via emergency were collected and analyzed using the Microsoft Excel (Microsoft Corp., Redmond, WA) spreadsheet.

There were 74% females out of the 73 included cases. Perforation was most common among the age group of 21–25 years. Abdominal pain was present in all patients, followed by vomiting in 46.6% of cases. Guarding was observed as the most common sign in 78.1% of patients. The ileum was the most common site of perforation in 41.1% of cases, while typhoid was the most common cause of bowel perforation in 20.5% of patients. In 42.5% of cases, stoma was made, followed by primary closure in 16.4% of patients.

This study shows an increased incidence of perforation in the ileum in the Pakistani population, different from the rest of the world and common in youth. An increased incidence of perforation due to typhoid highlights the prevalence and inadequate treatment of this disease.

© 2024 Zia, Fatir, Qadri, ul Haq, Khalid, Hussain, Licensee HBKU Press.
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2024-08-20
2024-12-22
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References

  1. Shashikumar HB, Madhu BS, Shyama S. Gastrointestinal perforations: An audit from a tertiary care teaching hospital, Mysore, India. Int Surg J. 2018Oct26; 5:(11):3484–8. https://doi.org/10.18203/2349-2902.isj20184613
     [Google Scholar]
  2. Devi PS, Manikantan G, Chisthi MM. Gastrointestinal perforations: A tertiary care center experience. Int Surg J. 2017Jan25; 4:(2):709–13. https://doi.org/10.18203/2349-2902.isj20184613
     [Google Scholar]
  3. Dharamdev D, Mascarenhas RM, Kumar A. A clinical study of the spectrum of gastro intestinal perforation peritonitis in a tertiary care centre. Int Surg J. 2021Apr28; 8:(5):1486–9. https://doi.org/10.18203/2349-2902.isj20211813
     [Google Scholar]
  4. Drakopoulos D, Arcon J, Freitag P, El-Ashmawy M, Lourens S, Beldi G, et al. Correlation of gastrointestinal perforation location and amount of free air and ascites on CT imaging. Abdomin Radiol. 2021Oct; 46:(10):4536–47. https://doi.org/10.1007/s00261-021-03128-2
     [Google Scholar]
  5. Pisano M, Zorcolo L, Merli C, Cimbanassi S, Poiasina E, Ceresoli M, et al. 2017 WSES guidelines on colon and rectal cancer emergencies: Obstruction and perforation. World J Emerg Surg. 2018Aug13; 13:36. https://doi.org/10.1186/s13017-018-0192-3
     [Google Scholar]
  6. Goel A, Bansal A, Gogia B. Outcome of gastrointestinal perforations due to blunt abdominal trauma. Int Surg J. 2018Jul24; 5:(8):2836–40. https://doi.org/10.18203/2349-2902.isj20183200
     [Google Scholar]
  7. Shahid MH, Khan FI, Askri Z, Asad A, Alam MA, Ali D, et al. One year of experience managing peritonitis secondary to gastrointestinal perforation at a tertiary care hospital: A retrospective analysis. Cureus. 2022Apr8; 14:(4):e23966. https://doi.org/10.7759/cureus.23966
     [Google Scholar]
  8. Afridi SP, Malik F, Ur-Rahman S, Shamim S, Samo KA. Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience. World J Emerg Surg. 2008Nov8; 3:31. https://doi.org/10.1186/1749-7922-3-31
     [Google Scholar]
  9. Hameed T, Kumar A, Sahni S, Bhatia R, Vidhyarthy AK. Emerging spectrum of perforation peritonitis in developing world. Front Surg. 2020Sep15; 7:50. https://doi.org/10.3389/fsurg.2020.00050
     [Google Scholar]
  10. Singh S, Satsangi A, Yadavalli SD, Singh B, Patil G. Nontraumatic small bowel perforation: A review of demographics, aetiological factors, clinical presentation, radiological findings along with hematological and histopathological evaluation. World J Surg Surgical Res. 2020; 3:1244. Available from: http://www.surgeryresearchjournal.com/abstract.php?aid=7396
     [Google Scholar]
  11. Rehman S, Dar S, Ahmed M, Raza M. Role of ileostomy in the management of typhoid perforation of small bowel in children. Ann King Edward Med Univ. 1997; 3:(1&2):23–5. https://doi.org/10.21649/akemu.v3i1&2.3461
     [Google Scholar]
  12. Al Bisher HM, Alsaleem HA, Althumairi A, Almadan AH, Alaseel H, Alqattan HS, et al. The incidence of acute peritonitis secondary to different sites of viscus perforation. Cureus. 2023Dec13; 15:(12):e50479. https://doi.org/10.7759/cureus.50479
     [Google Scholar]
  13. Ugochukwu AI, Amu OC, Nzegwu MA. Ileal perforation due to typhoid fever – review of operative management and outcome in an urban centre in Nigeria. Int J Surg. 2013; 11:(3):218–22. https://doi.org/10.1016/j.ijsu.2013.01.014
     [Google Scholar]
  14. Njarekkattuvalappil SK, Thomas M, Kapil A, Saigal K, Ray P, Anandan S, et al. Ileal perforation and enteric fever: Implications for burden of disease estimation. J Infect Dis. 2021Nov23; 224:(Suppl. 5):S522–8. https://doi.org/10.1093/infdis/jiab258
     [Google Scholar]
  15. Birkhold M, Coulibaly Y, Coulibaly O, Dembélé P, Kim DS, Sow S, et al. Morbidity and mortality of typhoid intestinal perforation among children in sub-Saharan Africa 1995-2019: A scoping review. World J Surg. 2020Sep; 44:(9):2892–902. https://doi.org/10.1007/s00268-020-05567-2
     [Google Scholar]
/content/journals/10.5339/jemtac.2024.13
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Clinico-pathologic characteristics of gastrointestinal perforations from a tertiary care hospital in Pakistan
Journal of Emergency Medicine, Trauma and Acute Care 2024, 13 (2024); https://doi.org/10.5339/jemtac.2024.13
/content/journals/10.5339/jemtac.2024.13
/content/journals/10.5339/jemtac.2024.13
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  • Article Type: Research Article
Keyword(s): abdominal pain, intestinal perforation, Pakistan, peptic ulcer, surgical anastomosis and typhoid

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