The Changes in Etiology and Clinical Features of Non-Traumatic Small Bowel Perforation.
- Author:
Byeong Gwan KIM
1
;
Ji Won KIM
;
Kook Lae LEE
;
Jae Kyung LEE
;
Ji Bong JEONG
Author Information
- Publication Type:Original Article
- Keywords: Intestinal Perforation; Tuberculosis, Gastrointestinal; Crohn Disease
- MeSH: Crohn Disease; Enteritis; Humans; Ileum; Intestinal Perforation; Jejunum; Sweat; Tuberculosis; Tuberculosis, Gastrointestinal; Tuberculosis, Pulmonary
- From:Intestinal Research 2012;10(2):189-195
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND/AIMS: We investigated the clinical features, and treatment outcomes in patients with non-traumatic small bowel perforations and compared these results to the previous study with patients who were diagnosed between 1997 and 2002. METHODS: Patients who diagnosed non-traumatic small bowel perforation between January 2003 and December 2008 were reviewed retrospectively. RESULTS: Of 38 patients of non-traumatic small bowel perforation, the most common etiologies were Crohn's disease (CD) (36.8%), followed by intestinal tuberculosis (ITB) (28.9%) and primary malignancy (15.8%). In the study of 2002, however, the most common etiologies were idiopathic (39.3%), followed by mechanical obstruction (28.6%) and infectious enteritis (14.3%). Of 38 cases, 8 perforation sites were found in the jejunum and 30 in the ileum. The number of perforations was single in 20, two in 15, and over 2 in 3 cases. Twenty-five patients were treated with resection and anastomosis, nine patients with primary closure, and four patients with both procedures. The site and number of perforations, surgical methods, and post-operative complication rates were similar to those of 2002. The perforation patients with ITB had more frequent night sweats and pulmonary tuberculosis findings than those with CD. CONCLUSIONS: Although the clinical features and surgical outcomes in the 2009 study were similar to those of the previous study conducted in 2003, the etiologies of perforations were different; CD and ITB were two most common etiologies. In addition, clinical characteristics such as night sweats or pulmonary tuberculosis were suggestive findings for the diagnosis of ITB.
