Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis

Area of Science:

• Gastroenterology
• Surgical Innovation
• Clinical Outcomes Research

Background:

• Small bowel perforations are uncommon but life-threatening if untreated.
• Current literature lacks specific classifications or treatment guidelines for small bowel perforations.
• Existing data on etiology, localization, and outcomes are limited.

Purpose of the Study:

• To analyze the characteristics of small bowel perforations.
• To develop a diagnostic and therapeutic algorithm for small bowel perforations.
• To identify predictors of complications and mortality in small bowel perforations.

Main Methods:

• Retrospective, monocentric data analysis of 267 small bowel perforation cases from 2010-2019.
• Categorization of perforations by location (duodenal, jejunal, ileal) and etiology (iatrogenic, ischemic, malignant, etc.).
• Evaluation of treatment approaches and mortality rates.

Main Results:

• Iatrogenic (41.9%) and ischemic (20.6%) etiologies were most common.
• The overall mortality rate was 14.23%, with the highest rates observed in ischemic perforations.
• Operative treatment with antibiotics was the primary therapeutic strategy (94.3%).

Conclusions:

• A diagnostic and therapeutic algorithm for small bowel perforations has been established.
• Small bowel perforations represent rare events with significant associated morbidity and mortality.
• Early diagnosis and assessment of underlying disease severity are crucial for predicting and managing complications.