scholarly journals CLINICAL STUDY AND MANAGEMENT OF PERITONITIS SECONDARY TO PERFORATED PEPTIC ULCER

2020 ◽  
pp. 1-4
Author(s):  
Sanjay Kumar Suman ◽  
Mukesh Kumar ◽  
Pawan Kumar Jha ◽  
Debarshi Jana
Keyword(s):  
Peptic Ulcer ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Perforated Peptic Ulcer ◽  
Morbidity And Mortality ◽  
Duodenal Perforation ◽  
High Morbidity ◽  
Peptic Ulcer Perforation ◽  
Common Cause ◽  
Ulcer Perforation

Background: Perforated peptic ulcer is the most common cause among all causes of gastrointestinal tract perforationwhich is an emergency condition of the abdomen that requires early recognition and timely surgical management. Peptic ulcer perforation is associated significant morbidity and mortality. The aim of study is to evaluate the incidence, clinical presentation, management and outcomes of the patient with peptic ulcer perforation undergoing emergency laparotomy. Methods: This retrospective study includes 45 patients who were operated for perforated peptic ulcer peritonitis atDepartment of Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar from October 2018 to March 2020. Paediatricpatients of age less than 14 years, patients presenting as recurrent perforation were excluded from the study. A detailed history, clinical presentation and routine investigations were done in all cases. Results: In the present study, most of the patients were male. Most of these patients presents with clinical signs ofperitonitis between 24-48 hours after onset of the pain. Among the patients of peptic ulcer perforation, duodenal perforation (93.3%) is more common and which is the most common cause of perforation peritonitis. The diagnosis is made clinically and confirmed by presence of gas under diaphragm on radiograph. Exploratory laparotomy with simple closure of perforation with omental patch was done in all cases. The most common post-operative complication was wound infection (57.5%). The overall mortality was 11.1%. Conclusions: Late presentation of peptic ulcer perforation is common with high morbidity and mortality. Surgicalintervention with Graham’s omentopexy with broad spectrum antibiotics is still commonly practiced.

scholarly journals Clinical study and management of peritonitis secondary to perforated peptic ulcer

2017 ◽  
Vol 4 (8) ◽  
pp. 2721
Author(s):  
Dushyant Kumar Rohit ◽  
R. S. Verma ◽  
Grishmraj Pandey
Keyword(s):  
Peptic Ulcer ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Perforated Peptic Ulcer ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Peptic Ulcer Perforation ◽  
Common Cause ◽  
Ulcer Perforation ◽  
Tract Perforation

Background: Perforated peptic ulcer is the most common cause among all causes of gastrointestinal tract perforation which is an emergency condition of the abdomen that requires early recognition and timely surgical management. Peptic ulcer perforation is associated significant morbidity and mortality. The aim of study is to evaluate the incidence, clinical presentation, management and outcomes of the patient with peptic ulcer perforation undergoing emergency laparotomy.Methods: This retrospective study includes 45 patients who were operated for perforated peptic ulcer peritonitis at Bundelkhand Medical College and Associated Hospital, Sagar from March 2015 to April 2017. Paediatric patients of age less than 14 years, patients presenting as recurrent perforation were excluded from the study. A detailed history, clinical presentation and routine investigations were done in all cases.Results: In the present study, most of the patients were male. Most of these patients presents with clinical signs of peritonitis between 24-48 hours after onset of the pain. Among the patients of peptic ulcer perforation, duodenal perforation (93.3%) is more common and which is the most common cause of perforation peritonitis. The diagnosis is made clinically and confirmed by presence of gas under diaphragm on radiograph. Exploratory laparotomy with simple closure of perforation with omental patch was done in all cases. The most common post-operative complication was wound infection (57.5%). The overall mortality was 11.1%.Conclusions: Late presentation of peptic ulcer perforation is common with high morbidity and mortality. Surgical intervention with Graham’s omentopexy with broad spectrum antibiotics is still commonly practiced.

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 RETROSPECTIVE STUDY OF PERFORATED PEPTIC ULCER: A TERTIARY HOSPITAL BASED STUDY

2020 ◽  
pp. 1-3
Author(s):  
Omprakash Raj ◽  
Sumit Dhruve
Keyword(s):  
Peptic Ulcer ◽  
Retrospective Study ◽  
Standard Procedure ◽  
Common Factor ◽  
Perforated Peptic Ulcer ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Peptic Ulcers ◽  
Case File ◽  
Ulcer Perforation

Background: Peptic Ulcer Perforation is an important and common emergency. One of the most dreaded and common complication of peptic ulcers is perforation. Perforations account for about 5% of peptic ulcers. Aim and Objectives: The aim of this study is clinical study of perforated peptic ulcer with objectives to assess the socio demographic distribution of peptic ulcer and to assess the clinical presentations and management of peptic ulcer perforation. Methodology: This was a retrospective study conducted in Chhattisgarh Institute of Medical Sciences Bilaspur in year 2018-2019. Total 158 patients were taken, who were diagnosed and operated for perforated peptic ulcer. Detail history and clinical findings were taken from case file. Result: a total 158 patients were studied, 76% were male, and 41-50 years age group was commonly affected. Alcohol consumption, old age, comorbid illness and pre admission delayed was most common factor. Abdominal pain i.e. 100% was most common presentation. Duodenal perforation was common i.e.38.60%. omentopaxy was preferable mode of repair perforation. Conclusion: Perforation of peptic ulcer is one of the common surgical emergencies and requires awareness and prompt management and operation. It mostly affects young and middle aged males in the thirties. Simple closure with omentopaxy is standard procedure.

scholarly journals PERFORATED PEPTIC ULCER

2011 ◽  
Vol 18 (01) ◽  
pp. 124-127
Author(s):  
SIKANDER HAYAT KHAN ◽  
MIRZA INAM UL HAQ ◽  
SHAHZAD AKHTAR AZIZ
Keyword(s):  
Peptic Ulcer ◽  
Past History ◽  
Armed Forces ◽  
Perforated Peptic Ulcer ◽  
Radiological Examination ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Ulcer Perforation ◽  
Operative Complications ◽  
Post Operative Complications

Objectives: To evaluate the epidemiology of peptic ulcer perforation in Armed Forces and further management / outcome of the patients. Methods: Data of 36 patients with perforated peptic ulcer collected. This data was analyzed on SPSS 13. Period and Setting: CMH Rawalpindi from Jan 1979 to July 1981, Jan 1985 to Dec 1987 and Jan 2001 to Dec 2003. Results: Out of 36 patients 35 were male and only one was female. Twenty four (67%) were between 31-50 years. No past history was taken from eight (22%) patients. Thirty four (94%) patients presented with duodenal perforation. Twenty patients (55%) had rigidity all over abdomen and peristalsis were present in ten (28%) patients who reported within twelve hours. Seventy eight (78%) were diagnosed by history and simple radiological examination. All the patients were treated by laparotomy (simple closure with omental patch). Post operative complications occur in ten (28%) patients and mortality rate was 8%. Conclusion: Predominantly the peptic ulcer perforation occurs between 30-50 years of age. The incidence reduces with succeeding years of study. Post operative complications were less in younger age group .Early diagnosis can be made easily by taking good history and performing simple radiological examination.

Clinical Presentation and Management of Patients with Peptic Ulcer Perforation in Kashmir - A Prospective Study

2021 ◽  
Vol 8 (27) ◽  
pp. 2368-2372
Author(s):  
Abdul Rashid Ganaie ◽  
Zuneera Banoo ◽  
Aamir Hussain Hela ◽  
Ishfaq Ahmad Hakeem ◽  
Haseeb Mohammad Khandwaw
Keyword(s):  
Peptic Ulcer ◽  
Clinical Presentation ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Medical Illness ◽  
Peptic Ulcer Perforation ◽  
Female Ratio ◽  
Ulcer Perforation ◽  
Plain Chest Radiograph ◽  
Number Of Patients

BACKGROUND Around 4 million people are affected by peptic ulcer diseases worldwide annually. The incidence of around 1.5 % to 3 % has been estimated. Peptic ulcer perforation presents with an overall mortality of 10 %. The management is also associated with significant post-operative morbidity and mortality regardless of whether laparoscopic or open repair is performed. In this study, we wanted to find out the incidence of peptic ulcer perforation and its management. METHODS Our study was a prospective observational study conducted in post graduate Department of Surgery, Government Medical College Srinagar, from October 2018 to November 2020. All patients were evaluated properly with all baseline investigations followed by X-ray chest and abdomen and ultrasonography (USG). RESULTS In our study, 136 patients were diagnosed as cases of peptic ulcer perforation. The maximum number of patients were in age group of 41 - 50 years (27.20 %). The male : female ratio was 14.1 : 1. Abdominal pain was present in all patients as presenting symptom followed by abdominal distension. In this study, 124 patients (91.2 %) had perforation in first part of duodenum, 9 patients (6.6 %) had perforation in prepyloric region and 3 (2.2 %) patients had perforation in body of stomach. Graham’s Patch repair was done in 133 patients, 1 patient underwent primary closure, and 2 patients underwent distal gastrectomy with gastrojejunostomy. CONCLUSIONS Our study shows that young people with perforated peptic ulcer have fewer coexisting medical illness, a lower complication rate and a more favorable outcome as compared to elderly patients with perforated peptic ulcer. A majority of such perforations are in 1st part of duodenum with male preponderance. A plain chest radiograph is sufficient to make diagnosis in the classic case of sudden onset epigastric pain. KEYWORDS Perforation Peritonitis, Management of Peptic Ulcer Perforation, Graham’s Repair, Clinical Presentation of Peptic Ulcer 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

NSAIDS: A RISK FACTOR AFFECTING PEPTIC ULCER PERFORATION

2021 ◽  
pp. 9-9
Author(s):  
Neelkamal Gupta ◽  
Mangtani Jitendra K ◽  
Khandelwal Dheeraj K
Keyword(s):  
Peptic Ulcer ◽  
Statistical Correlation ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Muscularis Mucosa ◽  
Time Duration ◽  
Ulcer Perforation ◽  
Medical College ◽  
Life Threatening ◽  
Gandhi Medical College

INTRODUCTION:Apeptic ulcer is a defect in the upper gastrointestinal mucosa that extends through the muscularis mucosa into deeper layers of the gut wall. Non-steroidal anti-inammatory drugs (NSAIDs) are the major risk factors for peptic ulcer disease.Long-term use of NSAIDs, however, can cause gastrointestinal (GI) ulcers and potentially life-threatening ulcer complications. MATERIALAND METHOD: The present study was conducted on 100 patients of peptic ulcer of either sex in Department of Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. History of any other co morbid illness and any drug being taken with its time duration were recorded in detail. RESULT AND DISCUSSION: From this study, it was observed that among the 69 patients of duodenal perforation, 73.91% were taking NSAID. Similarly among the 31 patients of gastric perforation 80.64% were taking NSAID. Overall total 76% patients were taking these drugs. CONCLUSION: It is concluded from this study that a strong statistical correlation was found between use of NSAIDs and peptic ulcer 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 Peptic ulcer perforation in young Indians the causation and the trend

2017 ◽  
Vol 5 (1) ◽  
pp. 200
Author(s):  
Geeta Sabhnani ◽  
Akula Nyna Sindhu
Keyword(s):  
Young Adults ◽  
Peptic Ulcer ◽  
Young Adult ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Adult Males ◽  
Ulcer Perforation ◽  
Surgical Emergencies ◽  
Causative Factors ◽  
History Of

Background: Peptic ulcer perforation is the commonest surgical emergencies in India. Recent emergency surgical procedures show an increasing trend in peptic ulcer perforation surgery in young adults. This study is carried out with an aim to understand the trend, causation and complications of peptic ulcer perforation in young Indians.Methods: A prospective observational study of young adult Indian patients operated for emergency peptic ulcer perforation for a 3 years period from January 2014 to January 2017 was carried out. The incidence, causative factors and the complications were analyzed.Results: In study of 150 patients, maximum incidence of 42.85% was seen in age group of 21 to 30 years that is young adults. 80% of them were males. 59% patients had blood group O. Association with smoking and alcoholism was seen in about 64% and 66.6% respectively. In about 13.33% there was an association seen with history of NSAID / steroid ingestion / treatment with proton pump inhibitors or H2antagonists.The duodenal perforation was found in 84.66%. In 90% the perforation was less than 1cm.Wound infection was the commonest complication among all patients. Mortality was seen in 3.33%.Conclusions: Peptic ulcer perforation shows increasing incidence in young adult males. The increased incidence shows association to smoking, alcoholism, irregular food habits, use of NSAIDS/steroids and overall stressed lifestyle. 

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