Small Bowel Perforations: Experiences in Indian General Surgery

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Dr Anekant Shiragave , Dr H B Janugade , Dr Anuroop Bhakkad


Small bowel perforations pose a significant challenge in Indian general surgery, shaping unique experiences and treatment approaches distinct from Western contexts. This study, conducted at Department of General Surgery, Krishna Institute of Medical Sciences, karad, delved into the intricacies of small bowel perforations within the Indian surgical landscape. Over an eight-month period spanning March to December 2022, 77 consecutive patients with perforation peritonitis were meticulously assessed. The study meticulously scrutinized clinical presentations, causative factors, perforation sites, surgical interventions, postoperative complications, and mortality rates. Among the findings, perforated duodenal ulcers (26.4%) and ileal typhoid perforations (26.4%) emerged as the primary culprits, underscoring the prominence of small bowel involvement in Indian surgical scenarios. Notably, small bowel tuberculosis (10.3%), stomach perforation (9.2%), and acute appendicitis-related perforations (5%) also featured prominently. A notable trend observed was the preponderance of perforations in the upper gastrointestinal tract, with the highest incidences in the ileum (39.1%) and duodenum (26.4%). This deviation from Western patterns highlights the unique nature of small bowel perforations in the Indian context. Despite advancements in surgical care, the overall mortality rate stood at 13%, emphasizing the severity of small bowel perforations. Interestingly, large bowel perforations and malignant perforations were relatively rare occurrences in this study cohort. This study provides valuable insights into the challenges and nuances of small bowel perforations in Indian general surgery. By understanding these distinct patterns, clinicians can tailor management strategies to improve outcomes and enhance patient care in this specialized domain.

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Dr Anuroop Bhakkad, D. A. S. , D. H. B. J. ,. (2024). Small Bowel Perforations: Experiences in Indian General Surgery. Obstetrics and Gynaecology Forum, 34(3s), 1090–1094. Retrieved from

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