A Clinical Study of Peptic Ulcer Perforation

Abstract

Background: Perforation is one of the most important complications of a peptic ulcer. In spite of modern management, it is still a life threatening emergency. Operative method is still the treatment of choice and simple closure of perforation with Graham's patch is an established procedure of choice in our institution. Material and Methods: A prospective study was conducted on 30 diagnosed patients of perforated peptic ulcer at Dr. Vasantrao Pawar Medical College, Nashik to study the clinical profile and clinical outcome of peptic ulcer perforation patients post operatively from August 2014 to December 2016. Results: A total of 30 patients were included, majority of patients presented in the 4th decade of life and 88.67% were males, 76.67% of the total patients had positive history suggestive of peptic ulcer disease and 36.66% patients had associated co morbidities, (36.67%) had severe dehydration, 10% patients presented with hypotension, with a systolic blood pressure of less than 90mmHg. In 23.33% of patients surgery was performed within 5 days of onset of acute abdominal pain and 16.67% presented with severe contamination of the peritoneal cavity, 33.33% presented with gastric perforation and 66.67% presented with duodenal perforation. 30% patients suffered from post operative wound infection and 30% patients suffered from post-operative respiratory infections. 16.67% patients presented with post operative sepsis. The mortality rate in this study was 10%. Conclusion: Perforated peptic ulcer is one of the most commonest acute abdominal emergencies. The outcome of the patient depends on the age of the patient, associated co morbidities, time interval between acute abdominal pain and surgery, timely resuscitation, contamination of the abdomen and post operative sepsis.