A study of surgical management of small bowel perforation

Background: Small bowel perforations are widely considered as an emergency intervention for a general surgeon, of which, terminal ileum perforations are common are most tricky to be dealt with. Developing countries like India shows increased cases of enteric fever, which correspond to acute abdomen as ileum perforations. This study shows various causative factors, diagnostic modalities and management of small bowel perforation. Objectives: • To study various causative factors of small bowel perforation. • To study various surgical procedures for perforation. • To study post surgical complications and management. Materials and Methods: A total of 50 cases with small bowel perforation was assessed. A detailed clinical history, physical examination and investigations were done for all patients. All patients included in study were operated after stabilisation and adequate resuscitation and post operative complications, morbidity and mortality assessed. The data is subsequently analysed to assess the usefulness of clinical features and investigations for the diagnosis and prognosis. Results: Study shows etiological distribution with 63.5% cases of enteric fever and trauma. Trauma and enteric fever contribute to major causes for multiple number of perforations. 54% of perforation cases were managed with simple closure in two layers. Most common post operative complication was wound infection (63%). Conclusion: This study denotes the etiological distribution of small bowel perforations, with highest number of cases of enteric fever and trauma. Various surgical procedures for management of perforation, with simple closure in two layers most commonly used in the current study, and post operative complications commonest seen in the study was wound infection.