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 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 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 Analysis of risk factors affecting the development of peptic ulcer perforation: case-control study

2020 ◽  
Author(s):  
Sami Akbulut ◽  
Ali Caliskan ◽  
Hasan Saritas ◽  
Khaled Demyati ◽  
Yilmaz Bilgic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Case Control Study ◽  
Case Control ◽  
Peptic Ulcer Perforation ◽  
Factors Affecting ◽  
Ulcer Perforation ◽  
Control Study

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. 

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
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Tertiary Care ◽  
Peptic Ulcer Perforation ◽  
Care Hospital ◽  
Chronic Alcoholic ◽  
Factors Affecting ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Duodenal Ulcer Perforation

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.

scholarly journals Factors affecting In-patient stay in patients operated for peptic ulcer perforation.

2020 ◽  
Vol 27 (10) ◽  
pp. 2076-2080
Author(s):  
Talha Kareem ◽  
Ali Rabbani ◽  
Sana Ahmad Khan ◽  
Muhammad Hamid Chaudhary ◽  
Muhammad Farrukh Aftab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Hospital Stay ◽  
Cross Sectional Study ◽  
Pulmonary Complications ◽  
Peptic Ulcer Perforation ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Ulcer Perforation ◽  
Patient Stay

Objectives: Recognizing the risk factors affecting the in-hospital stay of the patients operated for peptic ulcer perforation. Study Design: Cross Sectional study. Setting: General Surgical Wards, Nishtar Hospital Multan. Period: From 15th November 2018 to 5th of March 2019. Material & Methods: A total of 100 patients of all ages who had a peptic ulcer perforation were included. Patients with a perforation that wasn't attributable to a peptic ulcer e.g. malignancy or gastrinoma were excluded. Patients were asked about their smoking and drinking habits. Data was collected about various risk factors of peptic ulcer, their co-morbidities and the medications. Results: Gender, smoking, alcohol intake, H-pylori infection, size & site of perforation did not have a significant effect on hospital stay days. In patient stay days differed in groups based on comorbidities and medication. A weak correlation was found among age and stay days. Conclusion: Patients with complain of COPD and other pulmonary complications have a longer hospital stay in the hospital. The association of arthritis and hypertension could not be demonstrated comprehensively.

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 Seasonal Pattern of Peptic Ulcer Perforation in Central Anatolia

2021 ◽  
Vol 10 (31) ◽  
pp. 2451-2455
Author(s):  
Fatih Dal ◽  
Ugur Topal
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Large Scale ◽  
Female Gender ◽  
Central Anatolia ◽  
Peptic Ulcer Perforation ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Significant Difference ◽  
Group 2

BACKGROUND Previous studies have reported seasonal variations in peptic ulcer disease (PUD), but only few large-scale, population-based studies have been conducted in this regard. In this study, we wanted to present the seasonal relationship of peptic ulcer perforation admissions, seasonal variation of its incidence, modes of surgical management, the seasonal distribution of postoperative severe complications and the patient outcome. METHODS This is a retrospective cohort study. Patients hospitalized for peptic ulcer perforation between 1st January 2008 and 1st January 2020 were included in the study. The patients were divided into two groups according to postoperative complication status as Group1 - Clavien Dindo < 3 and Group 2 - Clavien Dindo > 3. Age, gender and seasonal periods were compared. In addition, patients were divided into three groups according to age as 18 – 40 yrs., 40 - 60 yrs. and over 60 yrs. The gender and complication status of the patients were also evaluated in seasonal groups. RESULTS 135 patients participated in our study. Group 1 constituted of 107 patients and Group 2 constituted of 28 patients. Admission to the hospital due to peptic ulcer perforation was most common in spring (29.6 %) and summer (29.6 %). Twenty - eight patients had Clavien - Dindo 3 or more complications. The mean age was higher in Group 2 (70.78 vs 50.2 P : 0.001) as well as female gender dominancy (60.7 % vs 29.9 %). In Group 2 winter months were more frequent (46,5 % vs 21.5 %); however, there was no significant difference between the seasons and the complication groups. In Group 2, female gender was more common in winter (21.7 % vs 69.2 % P:0.005) and autumn season (31.3 % vs 100 % P : 0.027). CONCLUSIONS In our study, we found an increased incidence of peptic ulcer perforation in spring and summer. For patients at higher risk, an appropriate pharmacological treatment can be arranged to reduce the risk of perforation during the risky season. KEY WORDS Peptic Ulcer Disease, Seasonal Change, Complication

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