An Observation on Hollow Viscus Perforation: Re-Apraisal of Its Magnitude and Treatment Modalities

Background: Hollow viscus perforation (HVP) is a serious surgical emergency that presents with high morbidity and mortality. The non-traumatic causes of HVP, including peptic ulcer disease, appendicitis, and diverticulitis, are often associated with lifestyle factors such as smoking, alcohol consumption, and NSAID use. Timely diagnosis and appropriate management are critical in improving patient outcomes. Aim: This study aims to assess the prevalence, risk factors, management, and outcomes of non-traumatic hollow viscus perforation in patients at Patna Medical College and Hospital, Patna. Methods: A prospective observational study was conducted from November 2019 to October 2020, including 126 patients diagnosed with non-traumatic hollow viscus perforation. Data were collected on patient demographics, clinical presentation, diagnostic methods, surgical interventions, complications, and outcomes. Statistical analysis was performed to determine the associations between risk factors and surgical outcomes. Results: The study found that the majority of patients were male (84.13%), with the highest incidence in the 30-39 age group (28.57%). The most common risk factors were smoking (47.62%) and NSAID use (31.74%). Duodenal perforations were the most common (60.31%), and Modified Grahm’s Patch repair was the most frequently performed surgery (69.84%). Postoperative complications included wound infection (49.21%) and respiratory issues (26.98%). The overall mortality rate was 4.76%, with most patients discharged within 14 days (80.95%). Conclusion: Non-traumatic hollow viscus perforation remains a significant surgical emergency, predominantly affecting middle-aged males. Peptic ulcer disease continues to be the leading cause, with smoking and NSAID use as major risk factors. Surgical management is generally effective, though complications are common. Early diagnosis and timely intervention are crucial to improving outcomes. Recommendations: Public health campaigns targeting smoking cessation and the responsible use of NSAIDs should be promoted. Furthermore, improving access to timely medical care and advanced diagnostic tools in rural and underserved areas can reduce mortality rates associated with hollow viscus perforation.