Perforated Peptic Ulcer Disease: Factors Predicting The Mortality And Morbidity In A Tertiary Care Centre In Southern India.

Introduction: Acute upper gastrointestinal (UGI) bleeding is a common medical emergency which is associated with significant morbidity and mortality. The annual incidence of UGI bleeding varies from 48 to 160 cases per 100,000 populations in the United States of America (USA), with a mortality rate of 7% to 10%. The aetiology and outcome of UGI bleeding varies significantly in different geographic regions depending on the demographic and socioeconomic characteristics of the local population. This study was done to evaluate the clinical profile and outcome of patients presenting with acute UGI bleeding at a tertiary care centre in Lumbini zone of Nepal.Material and Methods: This was a hospital based prospective observational study. All the patients who presented with acute UGI bleeding and fulfilled the inclusion criteria from 1st August 2013 to 31st July 2014 were included in the study. The study was cleared by the ethical review committee of the institute and written informed consent was taken from all the patients.Results: During the study period, 70 patients fulfilled the inclusion criteria and were subjected to statistical analysis. The mean age of patients in the present study was 55.11 ± 19.93 years. The majority of patients (30, 43%) were elder, belonging to the age group of more than 60 years. There were 55 (79%) male and 15 (21 %) female. The patients were mostly farmers by occupation accounting 29 (41 %) cases. Ethnically, 26 (3 7%) patients of UGI bleeding were from janajati group where majority of them had esophageal varices. Overall, the peptic ulcer disease was the leading cause of UGI bleeding seen in 26 (37%) patients followed by esophageal varices seen in 23 (33%) patients. 0 positive was the commonest blood group which was found in 28 (40%) of our patients. In our study 44 (63%) patients were alcohol consumers and 37 (53%) had coexisting comorbidities that added for the UGI bleeding related complications. During admission, 7 patients expired causing 10% mortality.Conclusion: Acute UGI bleeding was commonly seen in older age group patients with male preponderance. Peptic ulcer disease was the leading cause of the UGI bleeding. The mortality rate was found to be 10%. The mortality also increased with increasing age and patients with pre-existing co morbidities. Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 3-7

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FEASIBILITY OF ERAS (ENHANCED RECOVERY AFTER SURGERY) PROTOCOL IN PATIENTS UNDERGOING EMERGENCY REPAIR FOR PERFORATED PEPTIC ULCER DISEASE IN A TERTIARY CARE HOSPITAL

10.36106/ijsr/1219188 ◽

2021 ◽

pp. 41-43

Author(s):

Chayan Rui ◽

Chandan Roy Choudhury ◽

Puspak Ghosh

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Tertiary Care ◽

Perforated Peptic Ulcer ◽

Patch Repair ◽

Care Hospital ◽

Ulcer Disease ◽

Emergency Repair

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

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P-BN10 Seasonal Variation of Presentation of Perforated Peptic Ulcer Disease: An Overview of Patient Demographics, Management and Outcomes in Northern Ireland

British Journal of Surgery ◽

10.1093/bjs/znab430.011 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Bakhat Yawar ◽

Ahmed Marzouk ◽

Heba Ali ◽

Alsarah Diab ◽

Hassan Abdulrahman ◽

...

Keyword(s):

Peptic Ulcer ◽

Seasonal Variation ◽

Peptic Ulcer Disease ◽

Perforated Peptic Ulcer ◽

Peptic Ulcers ◽

Northern Irish ◽

Mortality And Morbidity ◽

Ulcer Disease ◽

Patient Demographics ◽

Acute Peritonitis

Abstract Background Perforated peptic ulcer disease is one of the most common causes of acute peritonitis. It carries significant mortality and morbidity. Several previous studies have reported a seasonal variation in presentation of patients with perforated ulcers. Here we present this study from a Northern Irish perspective on perforated peptic ulcers. Methods A retrospective cohort study was conducted on perforated peptic ulcer patients who presented to Altnagelvin Area Hospital emergency department between 2015 to 2020. Data on patient demographics, clinical presentation, investigations, management and outcomes were collected. Primary outcome was to investigate if seasonality was associated with incidence of perforated peptic ulcers. Follow-up data was also collected. Seasons were defined as per UK Met Office. Results Results: A total of 50 patients presented with perforated PUD. Male:female ratio was approximately 3:2. Peaks were noted in spring and winter. April was the most common month for presentation followed by December. Smoking was the most common risk factor followed by alcohol abuse. 14 patients (28%) were either very frail or had contained perforations and were conservatively managed. 3 deaths were noted (6%). 13 patients (26%) required ICU admission at some stage in their management. Conclusions Slight seasonal variation was noted in presentation of perforated peptic ulcers in our study with more common incidence in winter and spring months. The month of April was noted to have the peak incidence of the disease in our study.

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What are the benefits and harms of laparoscopic repair in people with perforated peptic ulcer disease?

Cochrane Clinical Answers ◽

10.1002/cca.398 ◽

2016 ◽

Author(s):

Kurinchi Gurusamy

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Laparoscopic Repair ◽

Perforated Peptic Ulcer ◽

Ulcer Disease

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Prevalence of syphilis and parasitic infection among blood donors in a tertiary-care centre in southern India

Annals of Tropical Medicine and Parasitology ◽

10.1080/00034983.1999.11813482 ◽

1999 ◽

Vol 93 (7) ◽

pp. 763-765

Author(s):

V. K. Harris ◽

S. C. Nair ◽

P. K. Das ◽

U. Sitaram ◽

Y. N. Bose ◽

...

Keyword(s):

Blood Donors ◽

Tertiary Care ◽

Parasitic Infection ◽

Southern India ◽

Care Centre ◽

Tertiary Care Centre

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Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20214371 ◽

2021 ◽

Vol 8 (11) ◽

pp. 3359

Author(s):

Lokesh M. G. ◽

S. Chandrashekar ◽

Arundathi Raikar ◽

Abhishek S. S.

Keyword(s):

Perioperative Complications ◽

Tertiary Care ◽

Surgical Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Hollow Viscus ◽

Mortality And Morbidity ◽

Medical College ◽

Threatening Condition ◽

Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

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Survival Analysis of Breast Cancer Patients Treated at a Tertiary Care Centre in Southern India

Annals of Oncology ◽

10.1093/annonc/mdu327.72 ◽

2014 ◽

Vol 25 ◽

pp. iv107

Author(s):

R. Arumugham ◽

A. Raj ◽

M. Nagarajan ◽

R. Vijilakshmi

Keyword(s):

Breast Cancer ◽

Survival Analysis ◽

Cancer Patients ◽

Tertiary Care ◽

Southern India ◽

Care Centre ◽

Breast Cancer Patients ◽

Tertiary Care Centre

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Association of Helicobacter Pylori with Peptic Ulcer Perforation

Journal of BP Koirala Institute of Health Sciences ◽

10.3126/jbpkihs.v2i1.24960 ◽

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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