A prospective study on etiology and outcomes of non-traumatic perforation of gastrointestinal tract

Introduction: Perforation of the gastrointestinal tract is the commonest surgical emergencies encountered in the emergency department. Peptic ulcer, neoplasms, infections are the common causes for perforation. The management of such perforations was determined by the location of perforation, its dimension and associated comorbidities. The aim of the study is to analyse the incidence, demographic details, etiological factors, location, surgical outcome and postoperative complications of non-traumatic gastrointestinal tract perforation in our tertiary care centre.Materials and Methods: This study was conducted on 79 patients admitted in general surgery department at Mahatma Gandhi Memorial Govt Hospital, Trichy during the period of one year from September 2021 to September 2022 who presented with acute abdominal pain with radiological evidence of pneumoperitoneum. Clinical history was taken and comorbid illness was recorded. Radiological investigations like X-ray and CECT for needed cases was done. Emergency surgeries were performed and postoperative clinical outcomes were studied.Results: Peptic ulcer perforation was commonest in our study seen in 43 patients (54.43%). Gastric antrum was found to be the commonest site of perforation in 26 patients (37.14%). Malignant perforation seen in patients above 4th decade. Surgical site infection was the commonest post operative complication seen in 15 patients (57.69%). Mortality occurred in 6 cases (7.59%) who presented late with hemodynamic instabilityConclusion: Non traumatic gastrointestinal perforation was common among males and in age group between 41 to 60 years. Peptic ulcer disease causing antral perforation was common followed by appendicular perforation , colonic perforation due to malignancy was least encountered. Early diagnosis, adequate resuscitative measures and urgent surgical intervention limits the morbidity and mortality to a greater extent.