Muhammad S Niam
Brawijaya University School of Medicine, Indonesia
Title: Acute non trauma gastric perforation: Operative vs. non operative
Biography
Biography: Muhammad S Niam
Abstract
Background: Gastric perforation is around 25–30% of acute abdomen cases presented in emergency department, with highly mortality and morbidity rate. Traditionally, laparotomy is believed as a gold standard. However, patients with ASA status ≥3 and Boey score ≥2 still had poor outcome. This research presented peritoneal drainage as an alternative to laparotomy for poor prognostic patients.
Objective: To determine the success rate of the peritoneal drainage procedure in the poor prognostic patients of gastric perforation cases in Saiful Anwar General Hospital Malang.
Method: Observational descriptive study was made in gastric perforation patients with the poor prognostics, determined by Boey score ≥2 and ASA score ≥3, who underwent laparotomy and peritoneal drainage procedure in RS Syaiful Anwar Malang in 2013. Using SPSS 17.0, the mortality in 30 days after each procedure was presented in crosstabulation and analyzed in crossectional method.
Results: 42 gastric perforation patients were in the poor prognostics, 18 patients underwent peritoneal drainage (42.85%), of them, 11 patients survived in for 30 days after the procedure (mortality rate = 38.89%). While of 24 patients who underwent laparotomy (57.14%), only 5 patients survived (mortality rate = 79.16 %). The mortality rate in laparotomy group was greater than peritoneal drainage group (OR: 5.971, CI :95).
Conclusion: In gastric perforation, patients with poor prognostics and peritoneal drainage have a better end result as compared with laparotomy procedure.