TITLE

Perforated Peptic Ulcer in South India: An Institutional Perspective

AUTHOR(S)
Arveen, Sankar; Jagdish, Sadasivan; Kadambari, Dharanipragada
PUB. DATE
August 2009
SOURCE
World Journal of Surgery;Aug2009, Vol. 33 Issue 8, p1600
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Perforated peptic ulcer is one of the most common surgical emergencies in South India. The advent of medical therapy for peptic ulcer has remarkably decreased the number of elective surgical procedures. The incidence of perforated peptic ulcer on the contrary, is increasing. The high incidence of complications necessitates the identification of factors associated with the morbidity and mortality of patients undergoing surgery for perforated peptic ulcer. Three hundred twenty-eight consecutive patients (299 men and 29 women) who underwent surgery for perforated peptic ulcer in our institute between November 2006 and June 2008 were studied prospectively. The mean age was 43.4 ± 14.4 years. The mean hospital stay was 10.9 ± 6.8 days. Of the 328 patients, 58 presented with shock, 159 presented with delay more than 24 h, and 24 had co-morbid illness. Wound infection and intra-abdominal abscess were encountered in 12.5% and 13.4% of the patients, respectively. Altogether, 85 patients had postoperative complications. Twenty-eight (8.5%) patients died. The mortality rate among men and women was 7.9% and 20.7%, respectively. Age ≥ 60 years, lag period longer than 24 h, presence of co-morbid illness, and shock at presentation were identified as independent predictors of postoperative complications. Shock at presentation, presence of co-morbid illness, American Society of Anesthesiologists (ASA) grade III or more, and renal failure were identified as independent predictors of mortality. Decreasing the delay in intervention and improving access to medical care may improve the outcome of patients undergoing surgery for perforated peptic ulcer. High-risk patients are those who present with shock and co-morbid illness.
ACCESSION #
43265307

 

Related Articles

  • Esofagectomía y reconstrucción primaria por perforación esofágica. Acín-Gándara, Débora; Limones-Esteban, Manuel; Ramos-Lojo, Beatriz; Delgado-Millán, Miguel Ángel; López-Herrero, Julio // Cirugia y Cirujanos;nov/dic2010, Vol. 78 Issue 6, p533 

    No abstract available.

  • Application of the nasogastric tube in patients undergoing surgery due to perforation of the gastrointestinal tract. Popik, Renata; Zaniewski, Maciej; Majewski, Eugeniusz; Hadasik, Dawid; Noras, Łukasz // Polish Surgery / Chirurgia Polska;2008, Vol. 10 Issue 2, p81 

    Background: Despite an introduction of more successful pharmacological treatment of peptic ulcer disease, the frequency of ulcer perforation, its main complication, has not decreased. Perforation of an ulceration is a state of emergency which requires urgent operation. For nearly a hundred...

  • Perforated Peptic Ulcer Treated by Simple Closure and Helicobacter Pylori Eradication. Rodríguez-Sanjuán, Juan C.; Fernández-Santiago, Roberto; García, Rosa A.; Trugeda, Soledad; Seco, Isabel; la de Torre, Fernando; Naranjo, Angel; Gómez-Fleitas, Manuel // World Journal of Surgery;Jul2005, Vol. 29 Issue 7, p849 

    Simple closure followed by Helicobacter pylori (Hp) eradication has become the most used procedure in perforated ulcer treatment. However, its efficacy and safety are still to be determined. In assess recurrence and re-perforation rates, and as a secondary objective, to analyze Hp infection...

  • Clinical and Economic Outcomes of Individuals With Severe Peptic Ulcer Hemorrhage and Nonbleeding Visible Vessel: An Analysis of Two Prospective Clinical Trials. Gralnek, Ian M.; Jensen, Dennis M.; Gornbein, Jeffrey; Kovacs, Thomas O. G.; Jutabha, Rome; Freeman, Martin L.; King, Joy; Jensen, Mary Ellen; Cheng, Susie; Machicado, Gustavo A.; Smith, James A.; Randall, Gayle M.; Sue, Michael // American Journal of Gastroenterology;Nov1998, Vol. 93 Issue 11, p2047 

    Objective: We report the clinical outcomes and direct medical costs of 155 patients with severe peptic ulcer hemorrhage and a nonbleeding visible vessel at emergency endoscopy treated with endoscopic hemostasis or medical-surgical therapy. Methods: In two consecutive, prospective, randomized,...

  • Acute upper gastrointestinal bleeding in octogenarians: Clinical outcome and factors related to mortality. Theocharis, George J.; Arvaniti, Vassiliki; Assimakopoulos, Stelios F.; Thomopoulos, Konstantinos C.; Xourgias, Vassilis; Mylonakou, Irini; Nikolopoulou, Vassiliki N.; Fujimoto, Kazuma; Lisman, Ton; Marshall, John K. // World Journal of Gastroenterology;7/7/2008, Vol. 14 Issue 25, p4047 

    AIM: To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians. METHODS: We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December...

  • Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: a case report. Camera, Luigi; Calabrese, Milena; Romeo, Valeria; Scordino, Fabrizio; Mainenti, Pier Paolo; Clemente, Marco; Rapicano, Gaetano; Salvatore, Marco // Journal of Medical Case Reports;2013, Vol. 7 Issue 1, p1 

    Introduction Peptic ulcer disease is still the major cause of gastrointestinal perforation despite major improvements in both diagnostic and therapeutic strategies. While the diagnosis of a perforated ulcer is straightforward in typical cases, its clinical onset may be subtle because of...

  • The “stamp method”: a new treatment for perforated peptic ulcer? Bertleff, M. J. O. E.; Liem, R. S. B.; Bartels, H. L.; Robinson, P. H.; Van der Werff, J. F. A.; Bonjer, H. J.; Lange, J. F. // Surgical Endoscopy;May2006, Vol. 20 Issue 5, p791 

    Background: The aim of this study was to develop a simple method for closure of a perforated peptic ulcer, making it more accessible for laparoscopic surgery. Methods: An experimental pilot study was performed using five male Wistar rats. The perforation was closed by a bioabsorbable patch made...

  • Peptic Ulcer.  // Current Medical Literature: Gastroenterology;2010, Vol. 29 Issue 1, p25 

    The article discusses several studies on peptic ulcer. A randomized trial was conducted on the use of intravenous exomeprazole for preventing recurrent bleeding among patients with peptic ulcer. A study focused on the high incidence of mortality and bleeding among patients with Helicobacter...

  • Acute Vagotomy Does Not Augment the Systemic Inflammatory Response in Patients with Peptic Ulcer Disease. Heider, T. Ryan; Koruda, Mark J.; Farrell, Timothy M.; Behrns, Kevin E. // American Surgeon;Apr2004, Vol. 70 Issue 4, p342 

    Recent accumulating evidence suggests that the vagus nerve modulates the response to peripheral immunologic stimuli and that intact vagal mediation decreases the systemic inflammatory response. We hypothesized that patients who had vagotomy for complicated peptic ulcer disease would be at...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics