Spectrum of gastrointestinal perforation and its determinants: a single-center hospital-based prospective observational study from North India

<ns4:p>Introduction Gastrointestinal perforation is a common surgical emergency associated with peritonitis, sepsis, postoperative morbidity, and mortality. This study assessed the etiological spectrum, clinical profile, complications, and outcomes of gastrointestinal perforation at a tertiary care institute in North India. Methods A single-center, hospital-based, prospective observational study was conducted in the Department of General Surgery, AIIMS Bathinda, from June to December 2024. Forty consecutive patients with clinically, radiologically, and/or intraoperatively confirmed gastrointestinal perforation were included. Data on demographics, etiology, clinical features, radiological findings, postoperative complications, and mortality were analyzed using descriptive statistics. Results Of 40 patients, most were aged 21–30 years [37.5%], followed by 31–40 years [32.5%]. Males predominated [82.5%]. Gastroduodenal perforation was the most common etiology [47.5%], followed by enteric perforation [42.5%], traumatic perforation [5.0%], and tubercular and other causes [2.5% each]. Abdominal pain and tachycardia were present in all patients. Air under the diaphragm was seen in 97.5%. Other common findings were abdominal tenderness [90.0%], dehydration [85.0%], abdominal distension [85.0%], guarding [72.5%], fever [60.0%], and constipation [30.0%]. Septicemia was the commonest postoperative complication [87.5%], followed by surgical site infection [62.5%] and respiratory complications [60.0%]. Overall mortality was 7.5%. Conclusion Gastroduodenal and enteric perforations were the predominant etiologies. The disease mainly affected young and middle-aged males and presented with classical features of perforated peritonitis. Early diagnosis, prompt referral, timely surgery, and structured postoperative care are essential to reduce morbidity and mortality.</ns4:p>