Abstract
We examined 62 cases of non-traumatic perforation of the small intestine which we experienced in our department from April 2009 to March 2014. Etiologies of the perforation were incarcerated hernia in 15 cases (24%), intestinal neoplasms in 9 cases (15%), adhesive intestinal obstruction in 9 cases (15%), Crohn’s disease in 8 cases (13%), iatrogenic and idiopathic perforation in 4 cases each and an intestinal ulcer in 3 cases. In only 5 cases (8.1%) was it possible to make a correct diagnosis of perforation of the small intestine before surgery and there were 6 cases (9.7%) who died during hospitalization. Perforation associated with the incarcerated hernia was common in older women. Perforation due to Crohn's disease was associated with a younger age at onset, but many postoperative complications including intraperitoneal abscess and wound infection were observed. In neoplastic perforation, the mortality rate within three months after surgery was as high as 60%. In addition, there were 4 patients who died of benign disease and they had severe preoperative comorbidities such as liver cirrhosis and renal failure. Although it is extremely difficult for us to diagnose non-traumatic perforations of small intestine, it is imperative that we do not miss the appropriate timing for the operation. However postoperative complications were observed in more than half of these cases. In cases with neoplastic perforation and those with severe comorbidities, the prognosis is poor.
