AYBERK DURSUN, GÜLŞEN YÜCEL OĞUZDOĞAN, KENAN TEKER, KORHAN TUNCER
Turkish Journal of Colorectal Disease - 2022;32(2):134-140
Aim: Small bowel perforations (SBP), which are among the rare causes of an acute abdomen, constitute a potentially fatal emergency. Non-traumatic isolated SBPs are encountered very infrequently. The aim of this study was to highlight the importance of correct diagnosis and early treatment with the help of computerized tomography (CT) findings and to contribute to the literature in light of the rarity of the condition. Method: Patients who were followed-up for non-traumatic SBP without additional organ injuries between 01.01.2015 and 01.03.2020 were included. Data including demographic and clinical characteristics, anamneses, mortality and morbidity, and type of surgery. Direct and indirect CT findings of the patients were evaluated. The study was retrospective. Results: A total of 59 patients, of whom 30 were male (50.8%), were included. Mean age was 62.4 years and 52.5% of the patients were older than 65 years. All patients underwent surgery and resection was preferred most frequently (83.1%). Mean duration of hospital stay was 11 days. Duration of hospital stay was significantly longer when major complications developed (p<0.05). The only significant relationship in subgroup analyses was identified between ileostomy and the occurrence of major complications (p<0.05). The most common causes of perforation were adhesions and metastatic tumor implants (16.9%). The most common cause of the metastases was lung cancer. CT showed intra-abdominal free fluid in 96.6% and free air in 61% of the patients. The rate of free air detection was higher with a history of malignancy (p<0.05). Conclusion: Early diagnosis and treatment is critical in reducing SBP-related mortality and morbidity. When SBP is suspected in the presence of a clinical picture of an acute abdomen, CT is an important guide. SBP should be considered in the differential diagnosis in patients with lung cancer who manifest a clinical picture of an acute abdomen.
