Patterns and Seasonal Variations of Perforated Peptic Ulcer Disease: Experience from Ethiopia

Abebe Bekele,Mulat Taye,Sahlu Wondimu,Seyoum Kassa,Daniel Zemenfes,Andualem Deneke

doi:10.4314/aas.v14i2.7

Abstract

Background : Perforated Peptic Ulcer Disease occurs in 2-10% of patients with ulcer disease and its principal treatment is surgical. Objective : To describe the socio-demographics of the patients, seasonal variation in its incidence, modes of surgical management and outcome of patients. Methods : This was a retrospective study on patients operated for acute perforated peptic ulcer at the Minilik II Memorial Referral Hospital, Ethiopia over a three-year period. Results : Eighty-seven patients were studied, 75 (86.2%) males were predominant. Current use of Chat and Cigarettes were reported by 44 (50.5%) and 41 (47.1%) of patients. Significant number of patients 39 (44.8 %) were operated during the Ethiopian rainy Season of July-September. The commonest presenting symptoms were sudden onset epigastric pain that become very severe in 83 (95.5%). Perforation of the anterior aspect of first part of the duodenum is the most common intra-operative findings in 88.7% (77) of cases and Pedicled omental patch repair after Cellan- Jones was performed in 83 (95.4%) of the patients. Atotal of 42 complications occurred in 20 (22.9%) of the patients, the commonest being wound infection. Ten (11.4%) underwent re-laparotomy. Nine patients (10.3%) died. Conclusion : This study has shown that perforated PUD affects young males who are smokers, alcohol users and khat chewers. It is also very common during the rainy Ethiopian months. We recommend further studies to study the interplay of these risk factors in the pathogenesis of perforations, especially their interaction with H.Pylori infection. Key words : Perforated PUD, Omental Patch, Seasonal variation, risk factors,

Highlights

Peptic Ulcer Disease (PUD) is a common disease of global public health concern
There is a wealth of literature worldwide regarding the decrease in the incidence of uncomplicated peptic ulcer disease after the introduction of H-receptor antagonists in the 1970s; proton-pump inhibitors (PPIs) and the discovery of Helicobacter pylori (H. pylori) as a causative agent in the 1980s
Conclusion:This study has shown that perforated PUD affects young males who are smokers, alcohol users and khat chewers

Summary

Introduction

Peptic Ulcer Disease (PUD) is a common disease of global public health concern. The incidence of elective surgery for peptic ulcer has markedly decreased [1,2,3]. Acute perforations are reported in 2-10% of patients with ulcer disease and accounts for more than 70% of deaths associated with PUD [4, 5]. The incidence of duodenal perforation is 7– 10 cases/100,000 adults per year [2]. Perforated Peptic Ulcer Disease occurs in 2-10% of patients with ulcer disease and its principal treatment is surgical. Methods:This was a retrospective study on patients operated for acute perforated peptic ulcer at the Minilik II Memorial Referral Hospital, Ethiopia over a three-year period. Perforation of the anterior aspect of first part of the duodenum is the most common intra-operative findings in 88.7% [77] of cases and Pedicled omental patch repair after Cellan-

Objectives

Methods

Conclusion