NONTRAUMATIC PERFORATIONS OF SMALL-INTESTINE

  • 1 January 1977
    • journal article
    • research article
    • Vol. 81  (2) , 184-188
Abstract
The etiology of nontraumatic small bowel perforations in 24 operated patients was as follows: strangulation in 5, diverticulum in 4, foreign bodies in 4, idiopathic in 3, Crohn''s disease in 2, malignant atrophic papulosis of Degos (MAP) in 2, and tuberculosis, carcinoid tumor, radiotherapy, and iatrogenic in 1. The high mortality rate in these patients appeared to be a function of the disease process rather than of the means of treatment. In favorable circumstances, as in strictly localized lesions with well known etiology and otherwise normal bowel, a simple closure of perforation is warranted. In more far advanced cases operated upon early enough, bowel resection and primary anastomosis is the best method of treatment, though it yielded poor results in this series. In seriously ill patients with the most widespread peritonitis, diversion procedures are advisable to protect the anastomosis.

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