Factors affecting morbidity and mortality in peptic ulcer perforation

Byakodi, K G.; Harini, B S; Teggimani, Vasant; Kabade, Narayan; Hiregoudar, Abhijit D.; Vishwas, M R

doi:10.18203/2349-2902.isj20181105

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…These include upper gastrointestinal bleeding, perforation, penetration, and malignant transformation. With the introduction of H2 receptor antagonists and proton pump inhibitors, the incidence of elective surgery for peptic ulcer (PU) disease has decreased dramatically, although complications of peptic ulcer disease such as perforation and bleeding have remained fairly constant [4] . A peptic ulcer can bleed chronically causing anemia due to blood loss.…”

Section: Introductionmentioning

confidence: 99%

Burden of peptic ulcer disease among patients with upper gastrointestinal bleeding

Siri¹,

Arpita²,

Neelendra³

2021

Int. J. Surg. Sci.

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Background: Peptic ulcer disease continues to be the most common cause of non-variceal upper gastrointestinal bleeding. The clinical presentation varies depending on the intensity of bleeding. It can range from an occult bleed to melena or hematemesis and haemorrhagic shock. The diagnostic procedure Esophagogastroduodenoscopy is gold standard for confirmation of peptic ulcer disease and is also helpful in identification of bleeding source. Irrespective of recent advances in medical treatment of peptic ulcer disease, it is important to quickly identify any signs and symptoms of bleeding. This allows for appropriate management of the bleed at an early stage. Therefore, it is important to know the frequency of peptic ulcer disease amongst upper GI bleeds. Aims and Objectives:The main aim of the current study is to identify the burden of peptic ulcer disease amongst patients with upper gastro-intestinal bleeding. Methodology: This retrospective study on 100 selected patients was conducted at the gastrointestinal unit, department of General Medicine, in a South Asian tertiary care centre, over a period of 6 months between May 2020 to December 2020.This period includes review of literature, collection and analysis of data, discussion and finalization of the report. 100 selected patients presenting to the outpatient department with GI symptoms and upper gastrointestinal bleeding, both male and female and above 18 years of age were enrolled in the study. The patient's medical history was recorded and diagnosis of peptic ulcer disease was confirmed by Esophagogastroduodenoscopy (EGD). Results: Out of 100 investigated cases of upper gastrointestinal bleeding, frequency of peptic ulcer disease was 53, of which 24 were duodenal ulcer, 21 were gastric ulcer,7 were with both gastric and duodenal ulcer and 1 was an esophageal ulcer. The age distribution in the study population ranged from 30 years to 90 years. With the youngest being 33 years of age and oldest 86years. The mean age was 55 years. Out of 100 cases 76 were males and 24 were females, giving a M: F ratio of 3:1.Risk factors included alcohol intake which was seen in 32 patients, smoking was seen in 41, and NSAID's use was seen in 8 patients; out of a total of 100 patients. Conclusion: Knowing the burden of peptic ulcer disease amongst upper gastrointestinal bleeds makes us aware of the morbidity it can cause. This makes us more alert and ensures mandatory evaluation for bleeding in any suspected or confirmed case of peptic ulcer disease.

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Section: Introductionmentioning

confidence: 99%

Burden of peptic ulcer disease among patients with upper gastrointestinal bleeding

Siri¹,

Arpita²,

Neelendra³

2021

Int. J. Surg. Sci.

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“…This finding is very similar to the with study done by Soro Kountele Gona et al from Côte d’Ivoire ( 36 ) and Phillipo et al from Tanzania ( 16 ) with 27.5% and 29.8% complications respectively. However, it is low as compared to report from KIMS Hospital, from India with 72.1% ( 37 ) and Nigeria ( 13 ) with a 63.2 % complication rate. Six patients developed patch failure of which five died with a case fatality rate of 83.33%.…”

Section: Discussionmentioning

confidence: 58%

“…During difficulty, CT-scan taken with oral contrast study is considered as a gold standard that can even detect small pneumoperitoneum ( 38 ). Abdominal ultrasonography has also been found to be superior to plain radiographs in the diagnosis of free intraperitoneal air ( 37 ). In our study, none of these other imaging studies were used for the diagnosis of PPU.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors that Affect Morbidity and Mortality in Patients with Perforated Peptic Ulcer Diseases in a Teaching Hospital

Seyoum¹,

Ethicha²,

Assefa³

et al. 2020

Ethiop J Health Sci

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Background: This study was done to identify risk factors that affect the morbidity and mortality of patients operated for a perforated peptic ulcer in a resource-limited setting.Methods: A two years (January 1, 2016 - December 30, 2018) retrospective cross- sectional study was done on patients admitted and operated for PPU at Yekatit 12 Hospital, Addis Ababa,Ethiopia.Results: A total of 93 patients were operated. The median age affected was 29 years (Range 15-75 years). Male to female ratio was 7.5:1. Chewing chat, smoking and alcohol use were seen in 22 (23.6%), 35(37.6%), and 34(36.5%), cases respectively. Only 23.6% gave previous history of dyspepsia. The median duration of illness was 48hours and the duodenal to gastric ulcer perforation ratio was 6.5:1. In majority of the cases (63.3%) the perforation diameter was <10mm (63.3%). Cellan-Jones repair of the perforations was done in 92.5% of cases. A total of 47 complications were seen in 25 cases. The total complications and mortality rates were 25(26.8%) and 6(6.5%) respectively. The most common postoperative complication was pneumonia (13.97%) followed by superficial surgical site infection (10.8%). Mortality rate was highest among patients >50yrs [AOR (95%CI) =2.4(2-30)]. Delayed presentation of >24 hours [AOR (95%CI) =4.3(1.4-13.5)] and a SBP <90mmhg [AOR (95%CI) =4.8(1-24)] were found to be significantly related with higher complication rate.Conclusions: Patients who presented early and immediate corrective measures were instituted had better outcomes while those seen late developed unfavorable out-come with significantly higher complications. Therefore, early detection and treatment of PPU is essential.

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“…Globally, over 4,000,000 individuals are affected by peptic ulcer disease annually, with a life time risk of perforation of 5% [1]. Whereas the global incidence of peptic ulcer perforation is reportedly low at 0.19-3% (1-2); its resulting mortality and morbidity is high; up to 30% and 50% respectively (3)(4); despite advances in endoscopic diagnostics, Helicobacter pylori (H. pylori) eradication treatment and use of antacids.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with peptic ulcer perforations in Uganda: a multi-hospital cross-sectional study

Edyedu,

Okedi,

Muhumuza

et al. 2024

BMC Gastroenterol

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Introduction Perforated peptic ulcer is the worst complication of peptic ulcer disease whose burden is disproportionately higher in low-income settings. However, there is paucity of published data on the patterns of perforated peptic ulcer in the region. The aim of this study was to determine the factors associated with anatomical patterns of peptic ulcer perforation, as well as the clinical, socio-demographic, and anatomical patterns among patients in Uganda. Methods This was a cross sectional study that enrolled 81 consecutive patients with perforated peptic ulcers. Using a structured pretested questionnaire the social demographic and clinical characteristics were obtained. At surgery, the patterns of the perforations were determined. Logistic regression was done in SPSS version 22 to determine the factors associated with the anatomical patterns. Results Perforated peptic ulcer disease was more prevalent among males (79.5%), peasants (56.8%) and those from rural areas (65.4%). Majority of study participants were of blood group O (43.2%). Gastric perforations were more common (74.1%). Majority of the perforations were found anteriorly (81.5%). Being a casual laborer was independently associated with lower odds of having a gastric perforation compared to being a peasant farmer (P < 0.05). Conclusion Public health campaigns aimed at prevention of peptic ulcer perforations should prioritize the males, peasants and those living in rural areas. When a patient in our setting is suspected to have a peptic ulcer perforation, the anterior part of the stomach should be considered as the most likely site involved more so in peasant farmers.

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Factors affecting morbidity and mortality in peptic ulcer perforation

Cited by 6 publications

References 7 publications

Burden of peptic ulcer disease among patients with upper gastrointestinal bleeding

Burden of peptic ulcer disease among patients with upper gastrointestinal bleeding

Risk Factors that Affect Morbidity and Mortality in Patients with Perforated Peptic Ulcer Diseases in a Teaching Hospital

Factors associated with peptic ulcer perforations in Uganda: a multi-hospital cross-sectional study

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