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KMID : 0988920120100020189
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Intestinal Research
2012 Volume.10 No. 2 p.189 ~ p.195
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The Changes in Etiology and Clinical Features of Non-Traumatic Small Bowel Perforation
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Kim Byeong-Gwan
Kim Ji-Won
Lee Kook-Lae
Lee Jae-Kyung
Jeong Ji-Bong
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Abstract
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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.
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KEYWORD
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Intestinal Perforation, Tuberculosis, Gastrointestinal, Crohn Disease
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