Perforated peptic ulcer: a clinical study at Shri. Shankaracharya institute of medical sciences Bhilai, Chhattisgarh

Abstract

Background: Perforation is a serious complication of PUD and patients with perforated peptic ulcer often carries high risk for morbidity and mortality. Acute perforated peptic ulcer is a leading cause of generalized peritonitis and its management has continued to be a challenging task in moderate resource setting environment. Aim and objective was to evaluate the different pattern of risk factors, clinical presentations, management and clinical outcome of patients with acute perforated peptic ulcer. Methods: This was a hospital based prospective observational study conducted in the Department of general surgery at Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chhattisgarh. Total of 79 cases with diagnosis of perforated peptic ulcer treated were taken as sample size. A specially designed proforma was used to collect information on patients' demographics, symptoms, complications, duration of hospital stay and treatment outcome. Results: In present study male predominance was seen in peptic perforation cases 68.75% and M:F ratio was 2.2:1. Mortality rate was 17.71%. Mean hospital stay among survivors was 11.8 days and among non survivors 5.5±3.73 days. Most common risk factor seen was alcohol, smoking, peptic ulcer disease and NSAIDs ingestion. Whereas the most common presentation was abdominal pain, signs of peritonitis, abdominal distension. Cases with APCHE 2 score >21 had 90% mortality. Conclusions: The present study conclude that perforated PUD is a life-threatening disease with high morbidities and mortalities. Male predominance, smoking and alcohol consumption and pain in abdomen were the common characteristics. APACHE 2 score was useful in assessing the risk of mortality.