Intestinal Perforation

This was as a result to the symptoms that the patients will have after undertaking such an operation and what outcome will have for the disease and its elimination. In the late 60s there was a new development in the management of the surgical intestinal perforation but the procedure still had its risks.

The mortality rate during the World War I from isolated injuries in the colon or the small intestine was known as 50% up to 60%, depending on the region.

These frightening numbers were made possible due to the small knowledge of the area of bowel injuries and the pathophysiological changes that will triggers such injuries, the clinical risks the different approaches and techniques in diagnosis, in trying to solve hypovolemia or hemodynamic chances, there was not used intravenous saline solutions, the lack of antibiotics, laparotomy was not recommended back then in any type of abdominal injuries and in general and technical maneuvers in assessing the bowel injuries or in mobilizing them were not recommended.

This type of incident can be described as a perforation in the upper bowel. There can be free perforation due to the spilling of the bowel contents directly into the abdominal cavity that will cause diffuse peritonitis, gastric perforation or duodenal gastric perforation.

Also ulcers can cause this type of rupture by creating a full and thick hole but at the very same time spillage will be prevented due to the contiguous organs wall, situation that will happen also when a duodenal ulcer will penetrate into the pancreas.

Lower bowel perforations as acute appendicitis or acute diverticulitis will have as an outcome free intraperitoneal contamination.

Small bowel injuries are statistically known to be less found in children then in adults but studies have shown that this will increase in time due to the eating habits and lack of exercise that a large majority of the patients has as a daily routine.

In the latter half of the 20th century, perforations of peptic ulcer disease was known as a common cause for mortality and morbidity but during time this has fallen in a comparison with the general decline of the development in such a disease. Nowadays, duodenal ulcer perforations are far more common then gastric ulcer perforations and the common ground will always be the gastric carcinoma.

The recommended treatment for intestinal perforation will always be surgery and after undertaking such a procedure a treatment of antibiotics specific for the patient will be administered. The risks of such a procedure have decreased in the last years, being now known as a simple surgical procedure in comparison with other emergencies and therapies that could affect the human body.

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