Diagnostic and therapeutic procedures of small bowel perforation: A retrospective monocentric cohort study

Background: Free perforation of the small bowel often has a rapid onset, and if left it untreated, can seriously affect a patient's prognosis. Therefore, in order to fully understand the etiology, diagnosis, and treatment of small bowel perforation (SBP), a classification of SBPs or treatment recommendations should be performed. Subjects and Methods: A retrospective, monocentric analysis of patients with SBPs was performed for the period of 2018–2022. Results: Over a 5-year period, 65 cases of SBP were documented. Perforation's localization was duodenal, jejunal, ileal, and undocumented. Eight etiologies were differentiated: obstructive (16.9%), ischemic (7.7%), diverticula-related (9.2%), inflammatory (9.2%), malignant (12.4%), traumatic (7.7%), foreign body (3.1%), and idiopathic (33.8%) perforations. Surgery combined with antibiotics was the most commonly used treatment (97.6%). The mortality rate was 6.2%, with a high rate for patients with ischemic and malignant perforations. Discussion: We have established the mature diagnostic and therapeutic treatment. Furthermore, it was found that the shorter the time between admission and operation, the better the prognosis, the better quality of life, with 12.3% ostomy rate. Conclusion: We have presented a comprehensive analysis of 65 patients treated for SBP over a 5year period, suggested a classification system of SBP according to the etiology, and described diagnostic and therapeutic steps for treatment.