scholarly journals P-BN10 Seasonal Variation of Presentation of Perforated Peptic Ulcer Disease: An Overview of Patient Demographics, Management and Outcomes in Northern Ireland

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Bakhat Yawar ◽  
Ahmed Marzouk ◽  
Heba Ali ◽  
Alsarah Diab ◽  
Hassan Abdulrahman ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Seasonal Variation ◽  
Peptic Ulcer Disease ◽  
Perforated Peptic Ulcer ◽  
Peptic Ulcers ◽  
Northern Irish ◽  
Mortality And Morbidity ◽  
Ulcer Disease ◽  
Patient Demographics ◽  
Acute Peritonitis

Abstract Background Perforated peptic ulcer disease is one of the most common causes of acute peritonitis. It carries significant mortality and morbidity. Several previous studies have reported a seasonal variation in presentation of patients with perforated ulcers. Here we present this study from a Northern Irish perspective on perforated peptic ulcers. Methods A retrospective cohort study was conducted on perforated peptic ulcer patients who presented to Altnagelvin Area Hospital emergency department between 2015 to 2020. Data on patient demographics, clinical presentation, investigations, management and outcomes were collected. Primary outcome was to investigate if seasonality was associated with incidence of perforated peptic ulcers. Follow-up data was also collected. Seasons were defined as per UK Met Office. Results Results:  A total of 50 patients presented with perforated PUD. Male:female ratio was approximately 3:2. Peaks were noted in spring and winter. April was the most common month for presentation followed by December. Smoking was the most common risk factor followed by alcohol abuse. 14 patients (28%) were either very frail or had contained perforations and were conservatively managed. 3 deaths were noted (6%). 13 patients (26%) required ICU admission at some stage in their management. Conclusions Slight seasonal variation was noted in presentation of perforated peptic ulcers in our study with more common incidence in winter and spring months. The month of April was noted to have the peak incidence of the disease in our study.

scholarly journals The surgical management of benign gastroduodenal perforation

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Elroy Weledji
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Perforated Peptic Ulcer ◽  
Operative Management ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
Abdominal Abscesses ◽  
Gastroduodenal Perforation ◽  
Definitive Surgery ◽  
Non Operative Management

Gastric perforations may be spontaneous or traumatic and most of the spontaneous perforation is due to peptic ulcer disease. Improved medical management of peptic ulceration has reduced the incidence of perforation, but still remains a common cause of peritonitis. The management of perforated peptic ulcer disease is still a subject of debate. The majority of perforated peptic ulcers are caused by Helicobacter pylori, so apart from simple closure, definitive surgery is not usually required. Perforated peptic ulcer is an indication for operation in nearly all cases except when the patient is unfit for surgery. However, with the current advances in anaesthetic approach and with the high incidence of intra-abdominal abscesses and sepsis, non-operative management has largely been abandoned.

FEASIBILITY OF ERAS (ENHANCED RECOVERY AFTER SURGERY) PROTOCOL IN PATIENTS UNDERGOING EMERGENCY REPAIR FOR PERFORATED PEPTIC ULCER DISEASE IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 41-43
Author(s):  
Chayan Rui ◽  
Chandan Roy Choudhury ◽  
Puspak Ghosh
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Tertiary Care ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Care Hospital ◽  
Ulcer Disease ◽  
Emergency Repair

Introduction: The surgical treatment of perforated peptic ulcer disease has evolved in parallel to advances in medical treatment of Peptic Ulcer Disease. Objective: To investigate the feasibility of ERAS (Enhanced Recovery after Surgery) Pathways in patients undergoing emergency repair for Perforated peptic ulcer disease. Materials and methods: Institutional based prospective analytical study. Indoor patients in Dept. of General Surgery in Medical College and Hospital Kolkata. January 2019 to June 2020. Study was conducted for 18 months.14 months was provided for data collection. Next 2 months for statistical analysis and another 2 months for thesis writing and submission. Conclusion: ERAS pathway (with some modications) seems to be safe and feasible in a highly selected subset of patients undergoing emergency Omental grahams patch repair of Perforated Peptic Ulcer Disease

scholarly journals Association of Helicobacter Pylori with Peptic Ulcer Perforation

2019 ◽  
Vol 2 (1) ◽  
pp. 4-10
Author(s):  
Sunit Agrawal ◽  
D Thakur ◽  
P Kafle ◽  
A Koirala ◽  
R K Sanjana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Peptic Ulcer Perforation ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
H Pylori

Background: Helicobacter pylori is found in more than 90% cases of peptic ulcer. This study examines the possibility of association of Helicobacter pylori in perforated peptic ulcer disease and its relation to persisting ulcer as well as the influence of other risk factors; namely: smoking, alcohol, current non-steroidal anti inflammatory drugs (NSAIDs) and steroid use. Materials and Methods: In this prospective study, total of 50 cases of peptic ulcer perforation admitted in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal were selected on the basis of the non-probability (purposive) sampling method. All patients who presented with suspected peptic ulcer perforation were included in the study and the perforations were repaired by Modified Graham’s Patch and were given triple therapy postoperatively. The age, sex, incidence, mode of presentation, precipitating factors, association with the risk factors and postoperative complications were all evaluated and compared. Results: Of 50 patients studied, the age ranged from 17 to 75 years, mean age being 40.1 years with the peak incidence in the 3rd and 5th decades of life showing a male dominance (92%). H. pylori was seen in ulcer edge biopsy in 29 patients (58%). Most common clinical presentation was pain abdomen, the most common signs of perforation were tenderness, rebound tenderness and absent bowel sounds. The mean duration of stay in hospital in H. pylori positive patients was 12.07±8.15 days as compared with 11.1±5.12 days in H. pylori negative patients. The incidence of peptic ulcer perforation was higher in the patients consuming alcohol (64%) than smokers (48%), followed by NSAIDs user(22%). 20% of the patients with delayed presentation developed complications postoperatively. Perforated peptic ulcer was repaired by Modified Graham’s Patch Repair, followed by anti H. pylori therapy in all of them. Conclusion: Peptic ulcer perforation is quite common among the patients with peptic ulcer disease with history of chronic smoking, alcoholism and analgesic intake, more commonly in males. There is association of H. pylori in 58% of patients with peptic ulcer perforation.

scholarly journals Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosis

2017 ◽  
Vol 8 (5) ◽  
pp. 455-469 ◽  
Author(s):  
Massimo Tonolini ◽  
Anna Maria Ierardi ◽  
Elena Bracchi ◽  
Paolo Magistrelli ◽  
Adriana Vella ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Multidetector Ct ◽  
Perforated Peptic Ulcer ◽  
Ulcer Disease ◽  
Ct Findings

The Role of Gastric Acid in Preventing Foodborne Disease and How Bacteria Overcome Acid Conditions†

2003 ◽  
Vol 66 (7) ◽  
pp. 1292-1303 ◽  
Author(s):  
JAMES L. SMITH
Keyword(s):  
Peptic Ulcer ◽  
Acid Secretion ◽  
Peptic Ulcer Disease ◽  
Gastric Acid Secretion ◽  
Gastric Acid ◽  
Gastric Fluid ◽  
The Body ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
H Pylori

The secretion of hydrochloric acid by the stomach plays an important role in protecting the body against pathogens ingested with food or water. A gastric fluid pH of 1 to 2 is deleterious to many microbial pathogens; however, the neutralization of gastric acid by antacids or the inhibition of acid secretion by various drugs may increase the risk of food- or waterborne illnesses. Peptic ulcer disease is often treated by decreasing or eliminating gastric acid secretion, and such treatment blocks the protective antibacterial action of gastric fluid. The majority of peptic ulcer disease cases originate from Helicobacter pylori infections. Treatment of H. pylori–induced peptic ulcers with antibiotics reduces the need for drugs that inhibit gastric acid secretion and thereby diminishes the risk of food- and waterborne illness for peptic ulcer disease patients. Many bacterial pathogens, such as Escherichia coli, Salmonella Typhimurium, and H. pylori, can circumvent the acid conditions of the stomach by developing adaptive mechanisms that allow these bacteria to survive in acid environments. As a consequence, these bacteria can survive acidic stomach conditions and pass into the intestinal tract, where they can induce gastroenteritis.

Role of Empiric Anti-Fungal Therapy in the Treatment of Perforated Peptic Ulcer Disease: Review of the Evidence and Future Directions

2019 ◽  
Vol 20 (8) ◽  
pp. 593-600
Author(s):  
Jared M. Huston ◽  
Laura Kreiner ◽  
Vanessa P. Ho ◽  
James M. Sanders ◽  
Therese M. Duane
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Perforated Peptic Ulcer ◽  
Future Directions ◽  
Ulcer Disease ◽  
Anti Fungal

Perforated peptic ulcer disease in children: Association of corticosteroid therapy

1993 ◽  
Vol 28 (6) ◽  
pp. 785-787 ◽  
Author(s):  
Stephen W. Bickler ◽  
Marvin W. Harrison ◽  
John R. Campbell
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Corticosteroid Therapy ◽  
Perforated Peptic Ulcer ◽  
Ulcer Disease
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