Clinical study and management of hollow viscus perforation of abdomen

Dhanapal Pattanam Velappan, Selvam Kaveri


Background: Gastrointestinal perforation is a common abdominal emergency having a high morbidity and mortality. Surgery plays an important role in the management of perforation. Gastrointestinal perforation is a common abdominal emergency having a high morbidity and mortality.

Methods: 100 cases of hollow viscus perforation of the abdomen have been studied prospectively in detail during the period from May 2010 to July 2012. Cases were selected randomly from admissions in Government Mohankumaramangalam Medical College Hospital, Salem, Tamil Nadu, India. Clinical diagnosis of hollow viscus perforation confirmed by investigations or by laparotomy performed.

Results: The results obtained in the present study were analysed: Among hollow viscus perforation duodenal ulcer perforation was common (52 out of 100 cases). Next being appendicular perforation. Age group of 20-40 years were affected mainly. Males are affected more than females. Signs and symptoms of acute abdomen like acute abdominal pain vomiting fever may present tachycardia, hypotension, abdominal tenderness guarding\rigidity with obliteration of liver dullness and absence of bowel sounds and absolute constipation were predominant signs.

Conclusions: GI hollow viscus perforations cause significant morbidity and sometimes mortality. Hollow viscus perforation is the common cause of acute abdomen needing immediate effective surgical attention. A proper early diagnosis and adequate treatment can prevent complications. Surgical approach depends on the site, size, age of perforation and number of perforations.


Abdominal emergency, Morbidity, Mortality

Full Text:



Langell JT, Mulvihill SJ. Gastrointestinal perforation and the acute abdomen. Med Clin N Am. 2008;92:599-625.

Dhikav V, Singh S, Pande S, Chawla A, Anand KS. Non steroidal drug induced gastrointestinal toxicity:mechanisms and management. JIACM 2003;4:315-22.

Kellog LC. A treatise on peptic perforations. Surgery. 1939;6:524-30.

Donovan AJ, Berne TV, Donovan JA. Perforated duodenal ulcer: An alternative therapeutic plan. Arch Surg. 1998;133:1166-71.

Fontana D, Webster GD, Wier J. Approach to management of lesser curvature gastric perforations. Scott Med J. 1958;3:238-49.

Rao DCM, Mathur JC, Ramu D, Anand M. Gastrointestinal perforations- a study of 46 cases. Ind J Surg. 1984;94-6.

Espinoza R, Rodríguez A. Traumatic and nontraumatic perforation of hollow viscera. Surg Clin North Am. 1997;77(6):1291-304.

Torpy JM, Lynm C, Golub RM. Peptic ulcer disease. JAMA. 2012;307(12):1329-.

Drake FT, Mottey NE, Farrokhi ET, Florence MG, Johnson MG, Mock C, et al. Time to appendectomy and risk of perforation in acute appendicitis. JAMA Surg. 2014;149(8):837-44.

Chung IK, Lee JH, Lee SH, Kim SJ, Cho JY, Cho WY, et al. Therapeutic outcome in 1000 cases of endoscopic submucosal dissection for early gastric neoplasms: Korean ESD Study Group multicenter study. Gastrointest Endosc. 2009;69:1228-35.

Nitecki W. Colonoscopic injuries. Asian J Surg. 1997;20:283-6.