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Duodenal ulcer patients with or without complications admitted in the surgical departments of Rajshahi Medical College Hospital (RMCH) during the period of 13 years from 1980-1992 were studied retrospectively. Duodenal ulcer accounted for 10/1000 admission and five operations per week. Of the 1623 patients with uncomplicated ulcer, only 623 needed surgical treatment. However, all of the 1599 who presented with pyloric stenosis, 1047 with peritonitis due to perforation, and 13 with hematemesis were operated upon. This study confirms previously published reports of high incidence of duodenal ulcer admissions in the hospital but shows a diminishing number in the uncomplicated cases requiring surgery.

:Closure is a crucial factor in laparotomy wound. Fascial layers provide the major tensile strength in wound closure. Poor wound healing and development of wound infection in incisional wounds are the common complications of open abdominal surgery. Continuous fascial closure commonly practiced and the interrupted closures are also practiced by some surgeon with an assumption that it causes less pain and less wound infection. The aim of this study was to determine the rate of postoperative wound infection and severity of wound pain following interrupted and continuous abdominal wound closure. A comparative cross-sectional study was done at the Department of surgery, Sylhet MAG Osmani Medical College Hospital from 1st July 2007 to 30th June 2008. A total 100 patients of clean-contaminated elective laparotomy were selected. The patients were randomly divided into two groups. Every odds number was included in group-I (interrupted suture) and every even number was included in group-II (continuous suture). Total 14% wound infection was detected in interrupted suture group where as wound infection was 18% in continuous suture group of wound closure. Though the wound infection is higher in group-II but the difference of wound infection is not statistically significant between two groups. The wound pain assessed in seven postoperative days was higher in continuous closure group than interrupted group but the difference was not significant. There is no significant difference of wound infection and wound pain between interrupted and continuous suture group in clean-contaminated laparotomy.

Background: In acute abdominal conditions, chronic duodenal ulcer  perforation is a very common surgical emergency that overwhelm the surgical ward throughout the year. Especially in the tropics and more in our country, peptic ulcer disease causes a major health problem. Objectives: To assess the usefulness of the prognostic factors in terms of morbidity and mortality in the treatment of perforated duodenal ulcer patient. Methods: This was a prospective study during the period from January 2003 to December 2003 in M.A.G. Osmani Medical College Hospital, Sylhet. The study included 100 cases of perforated chronic duodenal ulcer. Patients were randomly collected from all surgical units of SOMCH, Sylhet. Operation was done by simple closure with omental graft in all cases. Data analyzed by appropriate statistical method (Mean, SD & l2 test). Results: Highly significant relationship was found between increased age (>50 years) of patients with perforated duodenal ulcer and mortality (p<0.001). Lethality rate was higher in patients operated after 24 hours of onset of symptom in relation to patients operated within 24 hours of onset of symptom, (p<0.05). Different postoperative complications were prevalent in patients operated after 24 hours of onset of symptom, on the other hand complication rate was low in patients operated within 24 hours (p<0.001). There was also longer hospital stay in lately operated patients (more above median) than patients operated within 24 hrs (p<0.001). Mortality was higher in cases of purulent peritoneal fluid, where as it was nil in case of billous and serosanguinous fluid (p<0.001). More complications were developed in patients with purulent peritoneal fluid in comparison to billous and serosanguinous nature (p<0.001). There was more mortality in patients with preoperative shock in comparison with no features of shock (p<0.001). More complications were noted in patients with preoperative shock than in patients with no features of shock (p<0.01). Conclusion: Delayed operation, preoperative shock, more age and gross peritoneal sepsis bear a direct relationship with outcome of treatment chronic duodenal ulcer perforation patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21060