Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
World J Emerg Surg. 2006 Mar 24;1:7. doi: 10.1186/1749-7922-1-7.
There is still confusion and controversy over the diagnosis and optimal surgical treatment of non traumatic terminal ileal perforation-a cause of obscure peritonitis.
This study was a prospective study aimed at evaluating the clinical profile, etiology and optimal surgical management of patients with nontraumatic terminal ileal perforation.
There were 79 cases of nontraumatic terminal ileal perforation; the causes for perforation were enteric fever(62%), nonspecific inflammation(26%), obstruction(6%), tuberculosis(4%) and radiation enteritis (1%). Simple closure of the perforation (49%) and end to side ileotransverse anastomosis(42%) were the mainstay of the surgical management.
Terminal ileal perforation should be suspected in all cases of peritonitis especially in developing countries and surgical treatment should be optimized taking various accounts like etiology, delay in surgery and operative findings into consideration to reduce the incidence of deadly complications like fecal fistula.
非创伤性末端回肠穿孔——一种原因不明腹膜炎的诊断和最佳手术治疗仍存在混淆和争议。
本研究为前瞻性研究，旨在评估非创伤性末端回肠穿孔患者的临床特征、病因和最佳手术治疗方法。
共 79 例非创伤性末端回肠穿孔；穿孔的原因是伤寒（62%）、非特异性炎症（26%）、梗阻（6%）、结核（4%）和放射性肠炎（1%）。穿孔的主要治疗方法是单纯缝合（49%）和端侧回横结肠吻合术（42%）。
腹膜炎，特别是在发展中国家，应怀疑有末端回肠穿孔，手术治疗应根据病因、手术延迟和手术发现等多种因素进行优化，以减少致命并发症如瘘的发生率。
