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Intestinal perforation in children.

H Wardhan1, A N Gangopadhayay, G D Singhal

  • 1Department of Surgery, Banaras Hindu University, Varanasi, India.

Australian Paediatric Journal
|April 1, 1989
PubMed
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Pediatric intestinal perforation in Varanasi was frequently caused by uncommon conditions like typhoid. Most patients over five years old showed pneumoperitoneum, and the high mortality rate underscores the severity of these surgical emergencies.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Infectious Diseases

Background:

  • Intestinal perforation in children is a critical surgical condition.
  • Etiologies and outcomes vary significantly across different geographical regions.
  • Understanding local patterns is crucial for timely diagnosis and management.

Purpose of the Study:

  • To analyze the causes, clinical presentation, and outcomes of intestinal perforation in pediatric patients.
  • To identify common and rare etiologies of intestinal perforation in the study population.
  • To evaluate diagnostic methods and microbial patterns associated with pediatric intestinal perforation.

Main Methods:

  • Retrospective analysis of 102 pediatric intestinal perforation cases over three years.

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  • Review of patient demographics, clinical history, surgical findings, and radiological data.
  • Microbiological analysis of peritoneal fluid cultures.

    • Main Results:

    • Enteric (typhoid) perforation, intussusception, Ascaris lumbricoides infestation, and appendicitis were major causes.
    • Radiological evidence of pneumoperitoneum was present in 88% of cases.
    • Escherichia coli and Klebsiella were common aerobes; Bacteroides fragilis, Clostridia, and Peptostreptococcus were frequent anaerobes.

    Conclusions:

    • Uncommon causes of intestinal perforation in children are prevalent in this region.
    • Prompt surgical intervention and appropriate antibiotic therapy are vital.
    • The high mortality rate (19%) highlights the need for improved diagnostic and therapeutic strategies.