NON TRAUMATIC GASTROINTESTINAL PERFORATION AS A CAUSE OF ACUTE ABDOMEN

Background Any part of the GI tract may become perforated, releasing gastric or intestinal contents into the peritoneal space. Causes vary. Symptoms develop suddenly, with severe pain and may be followed by signs of shock. Diagnosis is usually made by the presence of free air in the abdomen on imaging studies. Treatment is with fluid resuscitation, antibiotics, and surgery. Mortality varies with the underlying disorder and the patient’s general health. Objectives To study the clinical pattern of various gastrointestinal perforations in surgical emergency department in Sulaimany. Patients and methods This prospective study was done in Sulaimany Teaching Hospital, including all emergency, non-traumatic acute abdomen those were caused by gastrointestinal (GI) perforation from the 1st of February 2011 to the 1st of September 2012. A total of 100 patients were collected. Patient’s data were analyzed by history, examination and various laboratory investigations and radiological studies. Results The commonest cause of perforation was peptic ulcer (70%), nineteen cases (19%) were infection, and the remaining (11%) were from other causes. Seventy-two patients (72%) were male and (28%) were female, fifty cases were of age between 15-45 years. Most of the patients presented with pain in the abdomen (93%), eighty four (84%) had tenderness and rigidity, twenty cases (20%) had abdominal distension, twenty-six (26 %) were febrile, and (7%) had shock. Ninety-eight (98%) cases were surgically treated, of which 60 were recovered uneventfully, thirty-one cases developed complications and 8 died post-operatively. Conclusion To manage a case of perforated hollow viscus of any sort, a skilled surgical team which can handle these situations confidently is of prime importance.