scholarly journals A clinical study of factors affecting the prognosis in duodenal ulcer perforation cases in tertiary care hospital, Kanchipuram district

2019 ◽  
Vol 6 (12) ◽  
pp. 4290
Author(s):  
Dhinesh Babu K. ◽  
M. Bhaskar

Background: Peptic ulcer disease is an erosion of the lining of the stomach or duodenum. It is associated with potentially life-threatening complications such as bleeding, perforation and obstruction. The main predisposing factors for peptic ulcer perforation are smoking, use of non-steroidal anti-inflammatory drugs (NSAIDs), chronic stress, Helicobacter pylori infection, and age >60 years. In recent years, with introduction of proton pump inhibitors and increased knowledge of duodenal ulcer perforation (DUP) has decreased the incidence of DUP.Methods: 50 patients with DUP were studied prospectively with respect to age, gender, use of NSAIDs, morbidity, mortality and complications.Results: Out of 50 patients, the mean age of incidence DUP was 46 yrs, which is more common in males. And also 48% patients were chronic alcoholic and 52% patients were chronic smokers. Moreover, 14% patients were chronic NSAIDs users.Conclusions: Factors such as age, gender, use of NSAID, Alcohol and smoking affects the life expectancy of the patients, which leads to morbidity and mortality.

2021 ◽  
pp. 11-14
Author(s):  
Ketan Patel ◽  
Harshit Agarwal ◽  
Jitendra K. Mangtani ◽  
Neelkamal Gupta

Introduction: Peptic ulcer is a sore in the lining of stomach or the rst part of the duodenum. Peptic ulcer perforation with subsequent peritonitis is commonest complication of peptic ulcer disease and is a surgical emergency. It carries with it great morbidity and mortality. AIMS: To study the risk factors associated with peptic ulcer perforation in our setting. Objectives: To Assess the role of various risk factors like age, sex, previous use of NSAIDS, Smoking & other associated illness. To study the risk factors that affect operative outcome in peptic perforation peritonitis. Materials & Methods: All patients of peptic ulcer with perforation peritonitis on laparotomy are included in the study.Patients with peptic ulcer Perforation of age > 14 years. Results: Duodenal perforations were present In 69 cases out of 100 cases (69%). Gastric perforation was present in 31 cases (31%). In gastric cases 30 perforations were present on lesser curvature and pyloric Antrum and one perforation was present on posterior wall of stomach. Discussion: Present clinical study of peptic perforation has been carried out to nd out various risk factor associated with It's occurrence, investigation, clinical picture, preoperative ndings and post operative outcome and recurrence of perforation after taking Anti H. pylori regime was observed. Conclusion:In my study that H.pylori infection, smoking, use of NSAID's is signicant risk factor on peptic perforation


2011 ◽  
Vol 48 (3) ◽  
pp. 171-174 ◽  
Author(s):  
Sergio B. Marques ◽  
Rejane Mattar ◽  
Everson L. A. Artifon ◽  
Paulo Sakai ◽  
Flair José Carrilho

CONTEXT: In spite of Helicobacter pylori infection being the etiological cause of peptic ulcer and its high prevalence in Brazil, the prevalence of peptic ulcer disease has been poorly studied. OBJECTIVES: To verify the peptic ulcer disease prevalence in patients of a tertiary care hospital. METHODS: Diagnostic findings from 1,478 consecutive endoscopies were correlated with the urease test results for H. pylori infection diagnosis and demographic data in a total of 3,779 endoscopies performed in 2005. The mean age of the patients was 51.14 ± 16.46, being 613 (41.5%) men. RESULTS: Peptic ulcer was diagnosed in 494 (33.4%) patients with a mean age of 54.86 ± 14.53, 205 (52%) were men, being 391 (26.5%) duodenal ulcer and 103 (7%) gastric ulcer. Normal endoscopy was found in 272 (18.4%) patients with a mean age of 38.4 ± 15.22, being 49 (18%) men. The comparison of peptic ulcer group with the patients that had normal endoscopy revealed that H. pylori infection [P = 0.005; OR = 1.70; 95% CI = 1.17-2.47][ign], male gender [P<0.0001; OR = 5.53; 95%CI = 3.67-8.34][ign] and older age [P<0.0001; OR = 1.08; 95%CI = 1.06-1.09] increased the risk of peptic ulcers. The overall H. pylori prevalence was 53% (786). CONCLUSIONS: Prevalence of duodenal ulcer is high in a Brazilian population that had H. pylori infection associated with older age and male gender as important determinants to gastrointestinal diseases outcome. Future prospective studies should confirm these findings.


ISRN Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Rajandeep Singh Bali ◽  
Sushant Verma ◽  
P. N. Agarwal ◽  
Rajdeep Singh ◽  
Nikhil Talwar

Background. Perforation peritonitis is the one of the commonest emergency encountered by surgeons. The aim of this paper is to provide an overview of the spectrum of perforation peritonitis managed in a single unit of a tertiary care hospital in Delhi. Methods. A retrospective study was carried out between May 2010 and June 2013 in a single unit of the department of Surgery, Lok Nayak Hospital, Delhi. It included 400 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included. Results. The commonest cause of perforation peritonitis included 179 cases of peptic ulcer disease (150 duodenal ulcers and 29 gastric ulcers) followed by appendicitis (74 cases), typhoid fever (48 cases), tuberculosis (40 cases), and trauma (31). The overall mortality was 7%. Conclusions. Perforation peritonitis in India has a different spectrum as compared to the western countries. Peptic ulcer perforation, perforating appendicitis, typhoid, and tubercular perforations are the major causes of gastrointestinal perforations. Early surgical intervention under the cover of broad spectrum antibiotics preceded by adequate aggressive resuscitation and correction of electrolyte imbalances is imperative for good outcomes minimizing morbidity and mortality.


2021 ◽  
Vol 19 (2) ◽  
pp. 35-39
Author(s):  
Pradeep Chandra Sharma ◽  

Background: Peptic ulcer disease in the general population had lifetime prevalence of 5-10% with incidence of 0.1–0.3% per year. Despite the tremendous improvement in preventive therapies, the rate of complication of this disease is still high and is burdened by high morbidity and mortality. In present study, we aimed to study factors affecting mortality and morbidity in patients presenting with peritonitis due to duodenal ulcer perforation at our tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study conducted in patients admitted, diagnosed with duodenal ulcer perforation and surgically treated at our hospital. Results: In present study period total 56 patients were studied. All were male, most common age group was 51-60 years (37.5%) followed by 41-50 years (23.21%). Duration from onset of symptoms to admission was >24 hours (30.36%) in most of patients followed by 12-24 hours (28.57%). Most commons symptoms were pain in abdomen (100%), vomiting (100%). Anaemia (37.5%), LRTI and Pulmonary complications (19.64%), Diabetes mellitus (12.5%) and Hypertension (10.71%) were common comorbidities noted. Associated risk factors were previous history of PUD (41.07%), Alcohol use (64.29%), Cigarette smoking (51.79%) and Use of NSAIDs (12.5%). Presence of free gas under diaphragm was noted in 83.93% patients. Intraoperatively duodenal perforation diameter was 1–5 mm (60.71%) in most of patients followed by 6–10 mm (23.21%). Only 1 patient had duodenal perforation diameter was > 20mm. Common postoperative complications were wound infection (37.5%) and pulmonary infection (21.43%). In present study mortality within 1 month was noted in 13 patients (23.21%). Most common factors related to mortality were delayed presentation > 24 hours (61.54%), age > 60 years (46.15%), diabetes mellites (38.46%), Size of perforation > 1 cm (38.46%) and septicaemic shock (23.08%). Conclusion: Delayed presentation > 24 hours, age > 60 years size of perforation > 1 cm were common factors related to mortality in duodenal ulcer perforation patients.


2021 ◽  
pp. 41-43
Author(s):  
Chayan Rui ◽  
Chandan Roy Choudhury ◽  
Puspak Ghosh

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


2019 ◽  
Vol 2 (1) ◽  
pp. 4-10
Author(s):  
Sunit Agrawal ◽  
D Thakur ◽  
P Kafle ◽  
A Koirala ◽  
R K Sanjana ◽  
...  

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.


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