scholarly journals Comparative study between POMPP score versus Boey score to predict morbidity and mortality in peptic perforation peritonitis

2021 ◽  
Vol 8 (2) ◽  
pp. 543
Author(s):  
Bhanu Prakash K. R. ◽  
Subhas Patil ◽  
Manasa Mohan
Keyword(s):  
Peptic Ulcer ◽  
Morbidity And Mortality ◽  
High Rate ◽  
P Value ◽  
Peptic Ulcer Perforation ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Perforation Peritonitis

Background: Peptic ulcer disease (PUD) results from an imbalance between stomach acid-pepsin and mucosal defense barriers. It affects 4 million people worldwide annually. Peptic ulcer perforation is one of the most common surgical emergencies and is associated with a high rate of morbidity and mortality. This is due to presence of various risk factors among the population like H. pylori infection, long term NSAID use, alcohol ingestion, smoking and steroid use. Peptic ulcer perforation peritonitis usually requires an emergency surgical intervention and hence the need for this study, to compare POMPP and Boey scores as predictors of morbidity and mortality in patients with peptic perforation peritonitis.Methods: This prospective observational study was conducted in the hospitals attached to Bangalore Medical College and Research Institute from November 2018 to May 2020. All patients above 18 years with features of hollow viscus perforation with per-operative finding of perforated peptic ulcer were included in the study. Patients with histopathology suggestive of malignancy were excluded.Results: A total of 65 patients were included in the study. On analysis of the data by Chi-square test, P value of both POMPP and Boey scores was found to be <0.05 which is statistically significant. The most important predictive factors of mortality and morbidity were duration of perforation >24 hours, age >65 years and pre-operative shock.Conclusions: Both scoring systems are easy to use and can assist in accurate and early identification of high-risk patients and are important in predicting mortality and morbidity in patients with peptic ulcer perforation.

scholarly journals Factors affecting morbidity and mortality in peptic ulcer perforation

2018 ◽  
Vol 5 (4) ◽  
pp. 1335
Author(s):  
Kadasiddeshwara G. Byakodi ◽  
Harini B. S. ◽  
Vasant Teggimani ◽  
Narayan Kabade ◽  
Abhijit Hiregoudar ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Female Gender ◽  
Morbidity And Mortality ◽  
P Value ◽  
High Morbidity ◽  
Peptic Ulcer Perforation ◽  
Female Population ◽  
Ulcer Disease ◽  
Ulcer Perforation

Background: Peptic ulcer disease is very common disease in developing countries and so are its complications. With the introduction of H2 receptor antagonists and proton pump inhibitors, the incidence of elective surgery for peptic ulcer (PU) disease has decreased dramatically, although complications of peptic ulcer disease such as perforation and bleeding have remained fairly constant.Methods: A prospective study was conducted on43 patients presenting to KIMS Hospital, Hubli with features suggestive of hollow viscus perforation and intraoperative findings suggestive of peptic ulcer perforation from January 2015 to June 2016.Results: In this study, there were 43 cases of peptic ulcer perforation. Peptic ulcer perforation was common in third decade of life(n=12) with the mean age(SD) 39.88 years. Perforation is more common in males as compared to the female population 7.6:1. Post-operative morbidity is seen in 31 (72.1%) of patients and mortality in 4 (9.3%). Smoking, Alcohol beverage consumption, regular ingestion of NSAIDs were commonly seen in patients with peptic ulcer perforation but these factors were not significant risk factors for postoperative mortality and morbidity. Age ≥60 years (p-value 0.051), Female gender (p-value 0.012), Presence of co-morbid conditions (p-value 0.055), Shock on admission (p-value 0.029, perforation-surgery interval >24 hours (p-value 0.001), preoperative higher-grade ASA, purulent intraperitoneal collection (p-value 0.002) were statistically significant predictors of mortality.Conclusions: Perforated peptic ulcer (PPU) is a life-threatening disease with historically reported high morbidity and mortality rates. Age ≥60 years, female gender, presence of co-morbidities, preoperative shock, higher ASA grade, perforation-surgery interval >24 hours, Purulent intraperitoneal collection are inter-related statistically significant predictors of mortality. Therefore, proper resuscitation from shock, improving ASA grade and decreasing delay in surgery is needed to improve overall results.

scholarly journals Pre-operative serum albumin and body mass index as predictors of post-operative morbidity and mortality in perforation peritonitis secondary to peptic ulcer disease

2021 ◽  
Vol 8 (2) ◽  
pp. 589
Author(s):  
Bhanu Prakash K. R. ◽  
Manasa Mohan ◽  
Subhas Patil
Keyword(s):  
Body Mass Index ◽  
Peptic Ulcer ◽  
Serum Albumin ◽  
Peptic Ulcer Disease ◽  
Body Mass ◽  
Gastrointestinal Disease ◽  
Morbidity And Mortality ◽  
P Value ◽  
Ulcer Disease ◽  
Perforation Peritonitis

Background: Peptic ulcer disease (PUD) affects 4 million people worldwide annually. Perforated peptic ulcer is a serious complication of PUD and patients often present with acute abdomen that carries high risk for morbidity and mortality. This is worsened in patients who are malnourished. The incidence of malnutrition is around 30% in patients with gastrointestinal disease and is frequently unrecognized. Albumin or prealbumin levels may help identify these patients. Obesity is also another cause for morbidity and has deleterious effects on wound healing. Therefore this study was carried out to assess if preoperative serum albumin and body mass index can be used as predictors of morbidity and mortality in patients with perforated peptic ulcers.Methods: 70 patients with peptic perforation peritonitis presented to the hospitals attached to Bangalore Medical College and Research Institute from November 2018 to May 2020 and were included in the study. Pre-operative Serum Albumin and BMI was noted and the patients were followed up for 30 days.Results: Mean albumin level in our study was 3.01. The patients with Serum Albumin <3.5 g/dl have more complications compared to patients with >3.5 g/dl. Morbidity and mortality increases with severity of hypoalbuminemia. This study was statistically significant with a p value <0.05. In our study, we also found that patients with abnormal BMI have more complications than patients with normal BMI but it is statistically insignificant with a p value >0.05.Conclusions: Serum albumin is a good indicator for predicting postoperative morbidity and mortality in peritonitis secondary to peptic ulcer disease.

scholarly journals Use of Boey’s score in peptic perforation disease in the Nepalese population: a prospective observational study

2019 ◽  
Vol 22 (1) ◽  
pp. 2-6
Author(s):  
Rabin Koirala ◽  
Paras Pant ◽  
Nikhil Acharya ◽  
Asish Rajbhandary
Keyword(s):  
Peptic Ulcer ◽  
Observational Study ◽  
Hospital Stay ◽  
Prospective Observational Study ◽  
Postoperative Mortality ◽  
Length Of Hospital Stay ◽  
Morbidity And Mortality ◽  
Peptic Ulcer Perforation ◽  
Mortality And Morbidity ◽  
Ulcer Perforation

Introduction: Peptic ulcer perforation carries high mortality and morbidity. Boey’s score is shown to be a simple scoring system to help predict morbidity and mortality. This is a prospective observational study to evaluate the applicability of Boey’s score in predicting mortality and morbidity in Nepalese patients. Methods: This study was conducted in the Dept. of Surgery, Nepal Medical College and Teaching Hospital (NMCTH), Attarkhel, Jorpati between 1st of July 2012 to 30th June 2019 over a period of 7 years. This was a prospective observational study. All patients who underwent laparotomy for suspected peptic ulcer perforation peritonitis were included in the study. Results: Fourty-seven patients were included in the study. Male patients outnumbered females by a ratio of almost 4:1. Eighteen (38%) patients had Boey’s score of 1, and 7 (15 %) patients had a Boey’s score of 3. Overall postoperative mortality was 7 (15%). Boey’s score predicted morbidity and mortality with a p-value of <0.01. The length of hospital stay was also more in patients with a higher score and it was statistically significant. Conclusions: Boey’s score is both easy and effective in predicting postoperative morbidity, mortality and length of hospital stay.

scholarly journals Feasibility of laparoscopic repair of peptic ulcer perforation

2021 ◽  
Vol 8 (5) ◽  
pp. 1526
Author(s):  
Sanjay Sisodiya ◽  
Badri Prasad Patel
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Laparoscopic Repair ◽  
Peptic Ulcer Perforation ◽  
Concomitant Disease ◽  
Wound Infections ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Early Return ◽  
Perforation Peritonitis

Background: Perforation is a common complication of peptic ulcer disease and presents as Perforation peritonitis. It has the highest number of mortality among all complications (≈15%). In spite of modern progress in the management, it is still a life-threatening catastrophe. Emergency surgery for complicated cases required in 7% of hospitalized peptic ulcer disease patients. Factors such as >24 hours of history, concomitant disease, shock, post operated wound infections, all are associated with increase in mortality and morbidity.Methods: A Prospective, observational, single hospital base study done during the period from 2016 to 2020 in the Department of Surgery, Gandhi medical college Bhopal. Sample size was taken 63Results: 52 out 63 cases presented with perforation peritonitis included under study period, 11 cases were excluded due to death and absconding of cases. In rest 52 cases, 15 of them went through laparoscopic repair, 28.85% of the cases were shifted directly to ORG.Conclusions: Laparoscopic repair of peptic ulcer perforation is feasible if patient presents early to the hospital. All perforation peritonitis should give fair chance to repair laparoscopically if patient’s general condition and anesthetic permits. This is a good alternative for conventional open surgery with less post-operative pain, early return to normal activities, less hospital stays and few postoperative wound infections. Thus it can significantly decrease the economic burden. 

RISK FACTORS AFFECTING PEPTIC ULCER PERFORATION

2021 ◽  
pp. 11-14
Author(s):  
Ketan Patel ◽  
Harshit Agarwal ◽  
Jitendra K. Mangtani ◽  
Neelkamal Gupta
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peptic Ulcer ◽  
Posterior Wall ◽  
Peptic Ulcer Perforation ◽  
Factors Affecting ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Operative Outcome ◽  
Perforation Peritonitis

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

scholarly journals Spectrum of Perforation Peritonitis in a Rural Medical College

2016 ◽  
Vol 15 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Mohinder Kumar Malhotra ◽  
Rikki Singal ◽  
Kunal Chowdhary ◽  
Ram Gopal Sharma ◽  
Saurabh Sharma ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Medical Science ◽  
Major Complication ◽  
Morbidity And Mortality ◽  
Gallbladder Perforation ◽  
High Morbidity ◽  
Peptic Ulcer Perforation ◽  
Ulcer Perforation ◽  
Perforation Peritonitis ◽  
Operative Findings

Aim: Perforation peritonitis is the most common surgical emergency encountered by surgeons in India. The etiology and sites of perforation shows wide geographical variation. The objective of the study was to find the spectrum of perforation peritonitis & highlight its management at Maharishi Markendeshwar Institute of Medical Sciences & Research, Mullana (MMIMSR).Methods: 93 Operated patients of perforation peritonitis were studied retrospectively in terms of clinical presentation, duration, operative findings and postoperative morbidity and mortality over a period of two years between 2011 to 2013 at MMIMSR Mullana. All the patients had undergone emergency laparatomy under general anesthesia and sites of perforation were identified & managed.Results: The most common cause of perforation peritonititis noticed in our series was peptic ulcer perforation 43 cases (46%), followed by ileal perforation 30 cases (32%), appendicular perforation 6 cases (6.4%), gallbladder perforation 5 cases (5.3%) and all the jejunal perforation 6cases (6.4%) was post traumatic. Large bowel and malignant perforation were least common in our series. Highest no. of perforation noticed in upper part of Gastro intestinal tract as compared to western countries where perforations are seen in distal parts. Mortality was of 11 cases (11.8%) & morbidity was noticed in 55 cases (59%).Conclusion: Peptic ulcer perforation peritonitis is the leading etiology. Mortality is comparable to that of best centre. Aggressive resuscitation and early minimum surgery are required to avoid the high morbidity and mortality. Major complication noticed was wound infection and dehiscence.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.70-73

scholarly journals Peptic Ulcer Perforation: An Enigma Since Antiquity

2021 ◽  
pp. 67-71
Author(s):  
Sujan Narayan Agrawal
Keyword(s):  
Peptic Ulcer ◽  
Medical Condition ◽  
Economic Status ◽  
Treatment Options ◽  
Peptic Ulcer Perforation ◽  
Peptic Ulcers ◽  
Mortality And Morbidity ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
H Pylori

Peptic ulcer disease (PUD) is a serious medical condition. The perforation of peptic ulcers (PPU) causes a steep rise in mortality and morbidity. It accounts for 70% of deaths associated with PUD. More than 60% of perforations occur in the anterior wall of the duodenum, while 20% of it is in the antrum. The gastric ulcer perforation contributes to approximately 20% and is in lesser curvature. The risk factor includes non-steroidal anti-inflammatory drugs (NSAID), Helicobactor pylori (H. Pylori), smoking, alcoholism, Corticosteroid, and stress are some of the risk factors. There is a change in the epidemiology of PUD recently. The improvement is remarkable and is due to improved socio-economic status, identification and treatment of Helicobacter pylori, and introduction of proton pump inhibitors. The H pylori infection remains one of the most important causes of PUD and its complications like PPU. The reason for reviewing and writing this paper is to evaluate the most common ideas on the treatment of peptic ulcer perforation, opinion on conservative treatment, and surgical treatment options.

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.

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