To evaluate role of various clinical and diagnostics procedures in diagnosis of caecal perforation

Abstract

Study includes hundred patients admitted to surgical emergency with acute abdomen were selected for the study. There was not any preoperative selection criteria; the cases which were proven to be cases of perforation peritonitis on the basis of investigations and clinical examination were taken for study and considered for comparative study if laparotomy diagnosed to be case of caecal perforation. Inflammatory cause 22 cases (22%) which include caecal perforation secondary to ruptured liver abscess 14 cases, appendicular base with caecal wall perforation 4 cases. Obstructive cause 06 cases (06 %) include obstructed inguinal hernia 02 case, obstructive band 02 case and caecal volvulus 03 case. 04 cases (04%) of caecal perforation secondary to neoplastic etiology were studied. The common etiologies in descending order were Traumatic 68 cases (68%) which include multiple stab injury 40 cases (40%), blunt trauma abdomen 12 cases (12%), iatrogenic 10 cases (10%), caecal perforation secondary to arrow injury 1 case (2%), and blast injury 2 case (4%). Chi Square Test of statistical significance was applied between group A (right hemicolectomy with ileo transverse anastomosis) and group B (primary repair with omental patch, primary repair with proximal ileostomy and right hemicolectomy with ileo transverse colostomy) for testing association between between group A and group B. From total Nine parameters chi square test was found to be significant in seven parameters with p value 0.05. Reducing mortality in patients undergoing surgery for caecal perforations. Ileostomy-specific complications, however, increase the postoperative stay of the patient. These complications can be reduced, if not outright eliminated, by proper fashioning of the stoma and provision of adequate nursing care of the stoma. It should be recommended that ileostomy in these cases is only temporary and the extra cost and cost of management are burden to life of poor community.