Management of Hollow Viscous Gastric and Duodenal Perforation Cases by Surgical Method versus Non-Operative Management: A Comparative Study

N Durgaprasad; V Manmadharao; K Babji; K Satyarao

N Durgaprasad Assistant Professor, Department of General Surgery
V Manmadharao Associate Professor,Department of General Surgery
K Babji Professor, Department of General Surgery
K Satyarao Junior Resident, Department of General Surgery

Keywords: Defi nitive surgery, Hollow viscous perforation, Laparotomy

Abstract

Background: Upper gastrointestinal hollow viscous perforation is multifactorial and not fully understood even today. Hollow
viscous perforation of upper gastrointestinal i.e. Gastric and duodenal perforations presents to the causality with acute abdominal
pain and distension, hypotension and prostration.
Aims: The purpose of this study is to compare the outcome in patients with gastric or duodenal perforation by non-operative
management as against defi nitive surgery.
Materials and Methods: A prospective study of upper gastrointestinal hollow viscous perforation cases was undertaken in
Government General Hospital, Kakinada. 100 cases of perforation of duodenum and stomach have been included in this study.
Of them, 70 cases were managed by defi nitive surgery, and 30 cases were unfi t to undergo an anesthetic and surgical line of
management. This group was managed by bilateral fl ank drains. Follow-up regarding recovery was observed.
Results: Maximum age incidence of hollow viscous perforation (gastric and duodenal) is between 35 and 45 years. Maximum
sex incidence is in males - 80%. Of these 30 patients was managed by non-operative method. Non-operative management
was successful in total recovery in 66.66% of patients, which is very signifi cant. Out of the survived cases maximum number
are at the age of 35-45 years.
Conclusions: Non-operative management, by keeping bilateral fl ank drains, is a formidable line of management as an alternative
to surgical management in patients with compromised general condition, unfit for any type of anesthesia.

Author Biographies

N Durgaprasad, Assistant Professor, Department of General Surgery

Rangaraya Medical College, Kakinada, Andhra Pradesh, India

V Manmadharao, Associate Professor,Department of General Surgery

Rangaraya Medical College, Kakinada, Andhra Pradesh, India

K Babji, Professor, Department of General Surgery

Rangaraya Medical College, Kakinada, Andhra Pradesh, India

K Satyarao, Junior Resident, Department of General Surgery

Rangaraya Medical College, Kakinada, Andhra Pradesh, India

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