Publication:

Retrospective study of perforated peptic ulcer: a surgical emergency

Background Peptic ulcer disease and acid peptic disorder are medical diseases and now managed mainly by medical treatment with advent of H2 blockers, proton pump inhibitors and antibiotics, with eradication of Helicobacter pylori, the complications have reduced, but perforation of peptic ulcer is still frequently occurring and is always a surgical emergency.

Methods This is a retrospective study of patients who were diagnosed, managed and operated for perforated peptic ulcer at Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India from January 2009 to December 2014. Data of 373 patients were collected from case records using a standard proforma and their risk factors, post-operative progress and outcome were analysed.

Results In our study of 373 cases, patients between ages of 30-50 years (72%) were commonly affected and there was male predominance (83%). Smoking, alcohol consumption and improper treatment for peptic ulcer were major risk factors. The significantly related complications were due to co-morbid illness, age and delayed presentation for treatment.

Conclusions Perforated peptic ulcer (PPU) is a frequent surgical emergency in this southern part of our state, predominantly affecting young and middle aged male, may be because of dietary habits (very spicy food) and other risk factors. Surgical intervention is always warranted. Simple closure with omental patch is the standard procedure, followed by treatment for H. pylori eradication. It was effective and majority of patients survived despite delayed preoperative admission.