scholarly journals Endoscopic assessment and Helicobacter pylori status evaluation in operated cases of peptic ulcer perforation

2020 ◽  
Vol 7 (2) ◽  
pp. 535
Author(s):  
Prashant Rao ◽  
Sarika Mayekar ◽  
Vishwajit Pawar ◽  
Mohan Achyut Joshi
Keyword(s):  
Peptic Ulcer ◽  
Ulcer Healing ◽  
Eradication Therapy ◽  
Peptic Ulcer Perforation ◽  
Omental Patch ◽  
Ulcer Perforation ◽  
Reasonable Approach ◽  
Patch Closure ◽  
H Pylori ◽  
Endoscopic Assessment

Background: Helicobacter pylori’s role in delaying ulcer healing after surgical repair for peptic ulcer perforation causing ulcer persistence hasn’t been definitively established as it has been for uncomplicated ulcers.Methods: Authors performed an endoscopy and H. pylori status evaluation in 30 patients at an average of 6.2 weeks after simple omental patch closure for perforated peptic ulcer.Results: A positive H. pylori status was found in 12 patients (40%) of which 9 had active ulcers. None in the negative group had an active ulcer. H. pylori infection was the only factor found to be responsible for ulcer persistence after surgery.Conclusions: A reasonable approach would thus be to perform an endoscopy 6 weeks after surgery to assess ulcer healing and H. pylori status. H. pylori eradication therapy should then be selectively initialled for patients with an active ulcer or positive H. pylori status.

scholarly journals Prevalence of Helicobacter pylori in peptic ulcer perforation

2017 ◽  
Vol 4 (10) ◽  
pp. 3350 ◽  
Author(s):  
Binni John ◽  
Bipin P. Mathew ◽  
Vipin Chandran C.
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Eradication Therapy ◽  
Perforated Peptic Ulcer ◽  
Peptic Ulcer Perforation ◽  
Female Ratio ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
H Pylori

Background: Helicobacter pylori have an important role in the pathogenesis of peptic ulcer disease. The aim of the present study was to observe the prevalence of H. pylori in peptic ulcer perforation cases and the rationale of H. pylori eradication therapy post operatively and to investigate factors associated with peptic ulcer.Methods: This cross-sectional study was conducted at the Department of general surgery, Government Medical College, Kottayam for a period 20 months from March 2012 to October 2013 after getting approval from institutional ethics committee. A total of 113 patients were participated in the study after meeting inclusion criteria. After getting written consent from the patients with perforated peptic ulcer, resuscitation and laparotomy was performed in the emergency department. H. pyloriinfection was confirmed by histopathological examination by Giemsa staining. Based on the histopathological report, the prevalence of H. pylori infection in the patients was assessed and was given appropriate H. pylori eradication regimen.Results: The mean age of presentation of the patients was 52.81±14.5 years. Male to female ratio was 4.14:1. Out of 113 cases, 67 cases (59.3%) had duodenal ulcer perforation while 46 cases (40.7%) had gastric ulcer perforation. Of them 53(46.9%) cases were positive H. pylori positive. No significant association was found between the incidence of H. pylori infection in peptic ulcers with smoking, hypertension, diet intake, NSAIDS intake. In our study association between H. pylori and diabetes mellitus (p=0.02) found to be significant which can be further investigated.Conclusion: According to our study the prevalence of H. pylori infection in perforated peptic ulcer disease is 47% which must be considered as significant. Hence all the patients undergoing laparotomy for peptic ulcer perforation should be investigated for H. pylori infection and if positive we must start the anti H. pylori regimen for them, which is more cost effective.

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 Assessment of recent epidemiological trends in peptic ulcer perforation patients in an eastern indian tertiary hospital

2018 ◽  
Vol 9 (6) ◽  
pp. 68-75
Author(s):  
Bikash Chandra Ghosh ◽  
Ambar Gangopadhyay ◽  
Gautam Ghosh
Keyword(s):  
Peptic Ulcer ◽  
Urban Slum ◽  
Morbidity And Mortality ◽  
Patch Repair ◽  
Peptic Ulcer Perforation ◽  
Still Life ◽  
Management Options ◽  
Ulcer Perforation ◽  
Sequence Of Events ◽  
H Pylori

Background: Peptic Ulcer perforation is one of the most important and dreaded complication of peptic ulcer disease. In-spite of recent therapeutic management options available, it is still life threatening catastrophe. Sudden release of gastric and duodenal content in peritoneal cavity leads to devastating sequence of events which if not properly managed may lead to death. Age and Gender adjusted analysis of incidence, morbidity and mortality and the effect of ulcerogenic medications, addictions and H. Pylori infection in prognosis were studied here. Postoperative outcomes were also assessed after giving same type of treatments (Preoperative resuscitation, Graham’s Patch repair, and postoperative care) given by same surgical team.Aims and Objectives: The aims and objectives of this study were to investigate the latest trends of incidence, presentation, morbidity and mortality of benign perforated gastro-duodenal ulcer among the various age groups of population and to further study the risk factors associated with these events and study the association of addiction, ulcerogenic medications and H. Pylori infection.Materials and Methods: This observational descriptive study was conducted in R.G.Kar Medical College, Kolkata between the periods from January 2016 to June 2017 among 102 patients.Results: In this study of 102 patients 97% were male patients, maximum number of patient were from the age group 15 -30 years (45.1%).86.3% were from low socio- economic status and 40.2% residing in urban slum. Maximum number of patients presenting within 72 hrs (71%) having zero mortality. Seventy four percent of patients presented with shock if came between 4-5 days with 17.39% mortality. Patient presenting after 5 days had mortality of 75% and shock was 100% finding. Size <1 cm having 1% mortality but if size is >1 cm then mortality was >50.5%.Conclusion: Perforated peptic ulcer is common among males in second and third decade of their life with patients living in rural and urban slum commonly affected. Most common predisposing factors for PPU among younger population were addictions like smoking or alcohol intake. Among the elderly patients, intake of ulcerogenic medications like NSAID and steroids was the most common predisposing factor for PPU. Among patients of non-NSAID associated PPU, Helicobacter pylori infection was the major cause in the pathogenesis of PPU.Asian Journal of Medical Sciences Vol.9(6) 2018 68-75

scholarly journals H. pylori and peptic ulcer perforation: prevalence of infection and role in surgical outcome

2021 ◽  
Vol 8 (4) ◽  
pp. 1243
Author(s):  
Saad Anwar ◽  
Afzal Anees ◽  
Nishat Afroz ◽  
Sabiha Aziz
Keyword(s):  
Peptic Ulcer ◽  
Surgical Outcome ◽  
Perforated Peptic Ulcer ◽  
Rapid Urease Test ◽  
Peptic Ulcer Perforation ◽  
Care Hospital ◽  
Ulcer Perforation ◽  
Test Kit ◽  
Urease Test ◽  
H Pylori

Background: Perforated peptic ulcer is one of the most common surgical emergencies. Despite a definite association of H. pylori with peptic ulcer disease, its association with peptic ulcer perforation is still doubtful. The aim of the present study was to know the prevalence of H. pylori infection and its role in surgical outcome of patients.Methods: This prospective observational study was carried out at a tertiary care hospital of north India for a period of two years and included 136 consecutive patients of perforated peptic ulcer who underwent emergency laparotomy. H. pylori infection was tested on ulcer margin biopsy using rapid urease test kit and confirmed on histopathological examination.Results: 136 consecutive patients of perforated peptic ulcer were included in this study with mean age of 42.43 years and sex ratio of 11.4:1. H. pylori infection was present in fifty four percent (54%) of patients. There was no relationship of H. pylori infection with morbidity and mortality of patients.Conclusions: H. pylori infection should be assessed at the time of primary surgical management on biopsy specimen using rapid urease test and confirmed on histopathological examination. All positive patients should be subjected to H. pylori eradication therapy.

scholarly journals The prevalence of Helicobacter pylori in perforated peptic ulcer disease

2018 ◽  
Vol 5 (5) ◽  
pp. 1720
Author(s):  
Babar Rehmani ◽  
Priyank Pathak
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Rapid Urease Test ◽  
Peptic Ulcer Perforation ◽  
Mucosal Biopsy ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Urease Test ◽  
H Pylori

Background: Although the role of Helicobacter pylori infection in noncomplicated peptic ulcer disease has been definitively established, the precise relationship between the organism and ulcer complications is doubtful. Recurrent ulcer disease after peptic ulcer perforation mainly occurs in patients with H. pylori infection, which suggests that the microorganism plays an important role in this complication.Methods: This observational study was conducted in the Department of General Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of January 2013 to December 2013 and included 75 subjects who underwent exploratory laparotomy for peptic ulcer perforation. The tests used for the diagnosis of H. pylori are mucosal biopsy at the time of surgery, Rapid urease test (RUT), Stool antigen test.Results: In this study, H. pylori infection was found to be present in 61% of these patients as detected by biopsy. There were 66 males and 9 females. Infection with H. pylori is almost universal in patients aged more than 70 years.Conclusions: In the Indian context patients presenting with perforation should be tested for infection with H. pylori utilizing a gastric antral mucosal biopsy taken at the time of operation for histological analysis and eradication therapy should be advised to all those who are found positive.

A CROSS-SECTIONAL STUDY TO PREVALENCE OF HELICOBACTER PYLORI IN PEPTIC ULCER PERFORATION AT DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 4-5
Author(s):  
Ravindra Ravindra ◽  
Vijay Shankar Prasad ◽  
Debarshi Jana
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Perforated Peptic Ulcer ◽  
Cross Sectional Study ◽  
Peptic Ulcer Perforation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
H Pylori

Background: Helicobacter pylori have an important role in the pathogenesis of peptic ulcer disease. The aim of the present study was to observe the prevalence of H. pylori in peptic ulcer perforation cases and the rationale of H. pylori eradication therapy post operatively and to investigate factors associated with peptic ulcer. Methods: This cross-sectional study was conducted at the Upgraded Department of Surgery, Darbhanga Medical College & Hospital, Laheriasarai, Bihar. A total of 113 patients were participated in the study after meeting inclusion criteria. After getting written consent from the patients with perforated peptic ulcer, resuscitation and laparotomy was performed in the emergency department. H. pylori infection was conrmed by histopathological examination by Giemsa staining. Based on the histopathological report, the prevalence of H. pylori infection in the patients was assessed and was given appropriate H. pylori eradication regimen. Results: The mean age of presentation of the patients was 52.81±14.5 years. Male to female ratio was 4.14:1. Out of 113 cases, 67 cases (59.3%) had duodenal ulcer perforation while 46 cases (40.7%) had gastric ulcer perforation. Of them 53(46.9%) cases were positive H. pylori positive. No signicant association was found between the incidence of H. pylori infection in peptic ulcers with smoking, hypertension, diet intake, NSAIDS intake. In our study association between H. pylori and diabetes mellitus (p=0.02) found to be signicant which can be further investigated. Conclusion: According to our study the prevalence of H. pylori infection in perforated peptic ulcer disease is 47% which must be considered as signicant. Hence all the patients undergoing laparotomy for peptic ulcer perforation should be investigated for H. pylori infection and if positive we must start the anti H. pylori regimen for them, which is more cost effective.

scholarly journals Outcome of surgeries for non-traumatic hollow viscous perforations

2018 ◽  
Vol 5 (8) ◽  
pp. 2888
Author(s):  
Hota P. K. ◽  
Mahesh S. V. ◽  
Reddy Dilip Kumar
Keyword(s):  
Peptic Ulcer ◽  
Operative Procedure ◽  
Gastrointestinal Perforation ◽  
Treatment Modalities ◽  
Peptic Ulcer Perforation ◽  
Simple Closure ◽  
Omental Patch ◽  
Ulcer Perforation ◽  
Operative Findings ◽  
Physical Findings

Background: Patients with non-traumatic hollow viscous perforations present challenge to the surgeons and outcome depends upon location and surgeon skills. Present study was to investigate the outcome of surgeries for non-traumatic hollow viscous perforations.Methods: This is a prospective observational study carried out in surgical wards in Mamata General Hospital between October 2015 and September 2017 over a period of 02 years. Evaluation of all the patients fulfilling the inclusion and exclusion criteria with respect to history, physical findings, operative findings and postoperative complications in line with the predetermined objectives was done. Various treatment modalities available and their outcome were also evaluated.Results: Benign causes of gastrointestinal perforation constituted majority of non-traumatic gastrointestinal perforations. Peptic ulcer perforation (68%) was the major cause of gastrointestinal perforation. Most common site for non-traumatic gastrointestinal perforations was duodenum (48%). Simple closure with omental patch was the operative procedure done for all cases of peptic ulcer perforation and appendicectomy for appendicular perforation. Ileal perforations secondary to typhoid perforation were treated with resection and end-to-end anastomoses in the present study. Colonic perforation was managed with Hartmann’s procedure. Most common complication was SSI (34%). Mortality was 8% and was due to septicemia.Conclusions: Aggressive resuscitation and early meticulous surgery is required to decrease morbidity and mortality in hollow viscous perforation cases. 

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