Incidence and outcome of ileal perforation among hollow viscus perforation

Saravanan, M (2014) Incidence and outcome of ileal perforation among hollow viscus perforation. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

INTRODUCTION: World wide hollow viscus perforation was common emergency problem in surgical casualty department, incidence of hollow viscus perfartion is variable from regional wise statistics. But all over worldwide Male incidence was greater than female incidence. Male : female ratio was 4 : 1. In my study sex ratio outcome is 3.5 : 1. Life style modification, stress free life regularized food habit all will be a deciding factor for hollow viscus perforation AIM OF THE STUDY: Among small intestine perforation, the ileal perforation is the major root cause for faecal peritonitis that may lead to major wound infection, wound gaping that necessitate secondary suturing. Like appropriate measures are not taken timely patient may die due to septic shock. The major morbidity and mortality will be prevented by time being measures such as appropriate antibiotic, fluid management and resuscitation. In our institute 33% of ileal perforations are reported among hollow viscus perforation. The main aim of this study would be to identify: 1. various risk factors of ileal perforation, 2. outcome of ileal perforation among hollow viscus perforation. MATERIALS AND METHODS: Selectively, 60 patients are taken from Govt. Kilpauk Medical College and Govt. Royapettah Hospitals with effect from dec 2012 to july 2013. Patient are observed from casualty and in-patient department Inclusion criteria for this study: a. clinically and radiological diagnosed Hollow viscus perforation patient. b. age criteria between >15yrs and <60 yrs of age. c. patient taken for emergency laparotomy d. patient observed in sicu and post op ward. e. In post operative ward patient observed regarding: 1. Day of oral feed started. 2. Is there any surgical site infection occurred. 3. Patient undergone for wound gaping & secondary suturing. DISCUSSION: A study was conducted in Govt Kilpauk Medical College Hospital and Govt royapettah hospital by assessing the 60 cases of hollow viscus perforation. Among sixty patient 14 patient was female and 46 patient was male.Patient are included in this study based on clinical and radiological based evidence.Patient taken for emergency laparotomy procedure, closing of perforation by Primary closure, resection and anastomosis, patch closure. postoperatively patient kept in Sicu and surgical post operative ward. Post operative followup based on regarding day of oral feeds started, surgical wound infection, wound gaping and those patient undergone for secondary suturing. Among ileal perforation 8/18 patient wound became infected. 5/8 infected ileal perforation wound undergone secondary suturing. Those patient undergone for secondary suturing their DALY (daily adjusted life year) was more. Data analysed regarding food habits of every patient. Those patient had an hotel food habits, smoking, alcoholism, stress ful life they became as victim for hollow viscus perforation. The common age groups are 3rd and 4th decades. Among sixty patient 24 patient belongs to 3rd and 4th decades. Ileal perforation due to typhoid is an important etiological factor at 3rd and fourth week of infection. Widal test and HPE is an important test to rule out other etiological factors of perforation.

Item Type: Thesis (Masters)
Uncontrolled Keywords: incidence ; ileum ; viscus ; perforation ; typhoid ; duodenum ; jejunum.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 06 Jul 2018 16:24
Last Modified: 07 Jul 2018 15:20
URI: http://repository-tnmgrmu.ac.in/id/eprint/8659

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