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Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis
Background: Small bowel perforations are a rare diagnosis compared with esophageal, gastric, and colonic perforations. However, small bowel perforations can be fatal if left untreated. A classification of small bowel perforations or treatment recommendations do not exist to date. Methods: A retrospe...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572575/ https://www.ncbi.nlm.nih.gov/pubmed/36233616 http://dx.doi.org/10.3390/jcm11195748 |
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author | Onken, Flurina Senne, Moritz Königsrainer, Alfred Wichmann, Dörte |
author_facet | Onken, Flurina Senne, Moritz Königsrainer, Alfred Wichmann, Dörte |
author_sort | Onken, Flurina |
collection | PubMed |
description | Background: Small bowel perforations are a rare diagnosis compared with esophageal, gastric, and colonic perforations. However, small bowel perforations can be fatal if left untreated. A classification of small bowel perforations or treatment recommendations do not exist to date. Methods: A retrospective, monocentric, code-related data analysis of patients with small bowel perforations was performed for the period of 2010 to 2019. Results: Over a 10-year period, 267 cases of small bowel perforation in 257 patients (50.2% male and 49.8% female; mean age of 60.28 years) were documented. Perforation’s localization was 5% duodenal, 38% jejunal, 39% ileal, and 18% undocumented. Eight etiologies were differentiated: iatrogenic (41.9%), ischemic (20.6%), malignant (18.9%), inflammatory (8.2%), diverticula-associated (4.5%), traumatic (4.5%), foreign-body-associated (1.9%), and cryptical (1.5%) perforations. Operative treatment combined with antibiotics was the most commonly used therapeutic approach (94.3%). The mortality rate was 14.23%, with highest rate for patients with ischemic perforations. Discussion: An algorithm for diagnostic and therapeutic steps was established. Furthermore, it was found that small bowel perforations are rare events with poor outcomes. Time to diagnosis and grade of underlying disease are the most essential parameters to predict perforation-associated complications. |
format | Online Article Text |
id | pubmed-9572575 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-95725752022-10-17 Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis Onken, Flurina Senne, Moritz Königsrainer, Alfred Wichmann, Dörte J Clin Med Article Background: Small bowel perforations are a rare diagnosis compared with esophageal, gastric, and colonic perforations. However, small bowel perforations can be fatal if left untreated. A classification of small bowel perforations or treatment recommendations do not exist to date. Methods: A retrospective, monocentric, code-related data analysis of patients with small bowel perforations was performed for the period of 2010 to 2019. Results: Over a 10-year period, 267 cases of small bowel perforation in 257 patients (50.2% male and 49.8% female; mean age of 60.28 years) were documented. Perforation’s localization was 5% duodenal, 38% jejunal, 39% ileal, and 18% undocumented. Eight etiologies were differentiated: iatrogenic (41.9%), ischemic (20.6%), malignant (18.9%), inflammatory (8.2%), diverticula-associated (4.5%), traumatic (4.5%), foreign-body-associated (1.9%), and cryptical (1.5%) perforations. Operative treatment combined with antibiotics was the most commonly used therapeutic approach (94.3%). The mortality rate was 14.23%, with highest rate for patients with ischemic perforations. Discussion: An algorithm for diagnostic and therapeutic steps was established. Furthermore, it was found that small bowel perforations are rare events with poor outcomes. Time to diagnosis and grade of underlying disease are the most essential parameters to predict perforation-associated complications. MDPI 2022-09-28 /pmc/articles/PMC9572575/ /pubmed/36233616 http://dx.doi.org/10.3390/jcm11195748 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Onken, Flurina Senne, Moritz Königsrainer, Alfred Wichmann, Dörte Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis |
title | Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis |
title_full | Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis |
title_fullStr | Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis |
title_full_unstemmed | Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis |
title_short | Classification und Treatment Algorithm of Small Bowel Perforations Based on a Ten-Year Retrospective Analysis |
title_sort | classification und treatment algorithm of small bowel perforations based on a ten-year retrospective analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572575/ https://www.ncbi.nlm.nih.gov/pubmed/36233616 http://dx.doi.org/10.3390/jcm11195748 |
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