| The Changes in Etiology and Clinical Features of Non-Traumatic Small Bowel Perforation |
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Byeong Gwan Kim, Ji Won Kim, Kook Lae Lee, Jae Kyung Lee, Ji Bong Jeong |
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Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
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| 비외상성 소장천공의 원인 질환 및 임상 양상의 변화 |
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김병관, 김지원, 이국래, 이재경, 정지봉 |
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서울대학교 보라매병원 내과, 서울대학교 의과대학 내과학교실 |
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| Abstract |
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. (Intest Res 2012;10: 0-195) |
| Key Words:
Intestinal Perforation, Tuberculosis, Gastrointestinal, Crohn Disease |
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