Abstract
Perforated peptic ulcers in Belarus: past and present Vladimir M. LobankovDepartment of Hospital Surgery,Gomel State Medical University,Lange str. 5, 246000 Gomel, BelarusE-mail: lobankov1959@mail.ru Objective The monitoring of perforated peptic ulcer incidence in Belarus is reviewed for the years 1960–2004. Methods The review of the annual incidence of perforated peptic ulcers during 1960–2004 is based on the official statistics of the Belorussian Ministry of Public Health. The index of perforated ulcer incidence per 100,000 population has been derived, with the account of population changes during these years. Results Mild variations of these statistics were observed before the 90s with an insignifcant tendency to grow from the second half of the 70s to the first half of the 80s. The Chernobyl accident in 1986 was not followed by any response. The incidence of perforated peptic ulcers almost doubled in the first half of the 90s, regional differences in the statistics appeared. These changes coincided with the collapse of the USSR and deterioration of the living standards. Hence, the socioeconomic factor has a dominating influence governing the risk of peptic ulcer complications, perforations in particular. Conclusion The author emphasizes the need to promote the role of public prophylaxis and definite preventive surgery for the patients with a severe ulcer evolution. Key words: perforated peptic ulcer, incidence
Highlights
Perforation is a vitally dangerous complication occurring among 5–10% of peptic ulcer patients on the average [1, 2]
Most of ulcer patients belong to the active age, with a strong domination of ulcer incidence among men, ten times more often on the average than among women [8, 9]
A comparative statistical analysis of the perforated ulcer incidence and morbidity has been performed for each decade of the period in question
Summary
Perforation is a vitally dangerous complication occurring among 5–10% of peptic ulcer patients on the average [1, 2]. The duodenal localization accounts for the majority of ruptures (75–85%) [5,6,7]. Most of ulcer patients belong to the active age, with a strong domination of ulcer incidence among men, ten times more often on the average than among women [8, 9]. The international cohort studies show that mortality during the last 30 years has not been tending to reduce; it accounts for 5–13% in case of duodenal ulcer perforations, 2–3 times more in case of gastric ulcer perforations [13,14,15]. If the adequate medical treatment is not carried out, ulcer recurrence is observed among 50–70% patients during the first post-operation al year, about 60% and more have to undergo another operation before 10 years elapse due to the evolution of stenosis, re-perforation, massive hemorrhage or combined complications [16, 17]
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