Perforated Peptic Ulcer

Khan, Sikander Hayat; Haq, Mirza Inam Ul; Aziz, Shahzad Akhtar

doi:10.29309/tpmj/2011.18.01.1878

“…Our study concurred with findings in Ghana [ 24 ] and Nigeria [ 25 ]. However, this was in contrast to findings of Bhardwaj [ 26 ], Khan [ 27 ] and a Rwandese study by Rickard [ 28 ], in which duodenal perforations were over represented. In addition, our findings were incongruent to those from Tanzania [ 15 ], Kenya [ 29 ] and Southern Sudan [ 30 ] where the ratio of gastric to duodenal perforations were 1:12.7, 1:11.5 and 1:25 respectively.…”

Section: Discussioncontrasting

confidence: 92%

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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“…Over 75 percent of duodenal perforations happened before the age of 50. We highlight that gastroduodenal ulcers share a similar pathophysiology, particularly with H. pylori infestation 17 which was more prevalent in younger patients from lower socioeconomic groups, 17 despite the fact that we do not have a good reason for this shifting epidemiological profile. Since up to three out of every five patients in this research had no prior dyspeptic history, it has been shown that perforation may be the earliest sign of peptic ulcer disease.…”

Section: Resultsmentioning

confidence: 80%

“…Several additional African studies demonstrate a majority of duodenal perforation, despite a prior research from a city hospital in Ghana having revealed a similar conclusion 16 . We highlight that gastroduodenal ulcers share a similar pathophysiology, particularly with H. pylori infestation, 17 which was more prevalent in younger patients from lower socioeconomic groups, 24,25 despite the fact that we do not have a good reason for this shifting epidemiological profile. Studies from Southern and Northern Nigeria show that urease culture tests for antral biopsies had a high incidence of 81.4% and over 90% with serological testing among individuals with dyspepsia.While H. pylori testing was not accessible in our facility for this investigation, all patients with perforated ulcers underwent H. pylori eradication medication.…”

Section: Discussionmentioning

confidence: 78%

Clinical study of 104 cases of hollow viscus perforation with peritonititis in gastric and duodenal perforation at rural tertiary centre

Tanter,

Gond,

Pakkal

et al. 2023

JSAS

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Acute abdomen with peptic ulcer perforation is a common cause of emergency admission and surgery. This is the study that documents the presentation and outcome of perforation management in DBVPRMC, Loni. This is a prospective study of patients operated upon for perforation peritonitis between March 1, 2021, and March 23, 2023. A structured recorded after questionnaire containing patients demographics, operative findings, and outcome was discharge or death. There were 104 patients. 81 males and 23 females (M : F = 3.5 : 1). The age range was between 18 years and 95 years. The mean age was 48.99 years ± SD 16.1 years. The ratio of gastric to duodenal perforation was 1.88 : 1. Perforation was the first sign of peptic ulcer disease in 62 (59.6%). Pneumoperitoneum was detectable with plain radiographs in 95 (91%) patients. 72 (69.2%) had Graham’s Omentopexy. Death rate was 17.3%. We note that gastric perforation is a more commoner disease in our environment. Perforation is often the first sign of peptic ulcer disease. We identify spicy food, alcoholism and NSAIDs intake amongst patient as a risk factor for perforation. Early presentation is associated with good prognosis.

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Duodenal Perforation: Outcomes after Surgical Management at a Tertiary Care Centre—A Retrospective Cross-Sectional Study

Bojanapu

¹

,

Malani

²

,

Ray

³

et al. 2020

Surgery Research and Practice

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Introduction. Duodenal perforation is a common surgical emergency and carries mortality ranging from 4% to 30% reported in Western countries, but there is a paucity of reports from India. We aimed to determine the factors which influence the surgical outcomes in patients with duodenal perforation. Methods. We retrospectively analyzed prospectively collected data from January 2010 to December 2018. Results. A total of 55 patients were included in the study of which 69% (38) were males and 31% (17) were females (M : F = 4.5 : 2). The mean age was 52.3 years. The cause for duodenal perforation was duodenal ulcer (n = 25, 45.5%), followed by post-ERCP complications (n = 15, 27.3%), surgery (n = 11, 20%), and blunt trauma (n = 4, 7.2%) with perforations localized at D2 (n = 28, 51%) and at D1 (n = 27, 49%). Patients underwent primary repair with an additional diversion procedure (n = 28, 51%) and repair only in 18 (32.8%). There were 21 (38%) deaths. Patients with ERCP-associated duodenal perforation had longer hospital stay ( P ≤ 0.001 ), ICU stay ( P = 0.049 ), duration of drainage ( P ≤ 0.001 ), and higher leak rate ( P = 0.001 ) and re-exploration rate ( P = 0.037 ). A high mortality rate was seen in patients with preoperative organ failure (n = 18, 78% versus 9.4%, P = 0.001 ), postoperative leak (n = 7, 64% versus 32%, P = 0.05 ), and longer duration from onset of symptoms to surgery (≥4 days) ( P = 0.045 ). Conclusion. Perforation of the duodenum is associated with high morbidity and mortality regardless of its cause and is higher in those who have a longer interval to surgery, preoperative organ failure, and a postoperative leak.

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Perforated Peptic Ulcer

Cited by 8 publications

References 0 publications

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

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

Clinical study of 104 cases of hollow viscus perforation with peritonititis in gastric and duodenal perforation at rural tertiary centre

Duodenal Perforation: Outcomes after Surgical Management at a Tertiary Care Centre—A Retrospective Cross-Sectional Study

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