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Clinical study of peptic ulcer perforation in eastern India: An tertiary institution-based study

Nishith M Paul Ekka, Shital Malua.

Background: Every year peptic ulcer disease affects 4 million people around the world. Perforation is the second most common ulcer-related complication. Ulcer perforation was a lethal disease until surgical treatment was introduced.

Objectives: This study was performed to assess the demographic distribution of peptic ulcer, to assess the clinical presentations of peptic ulcer perforation, to evaluate the site of perforation and effective method of treatment, and to study the complication of peptic ulcer perforation and its management.

Material and Methods: This is a cross-sectional study, which was conducted from May 2013 until April 2016 at RIMS, Ranchi. A detailed history was taken and clinical examination of the patient was carried out at the time of admission. X-ray abdomen erect posture, leukocyte count, serum amylase were performed along with other investigations. After surgery, site of perforation type of surgery along with any complications and outcome of treatment were recorded. Patients were followed-up for 30 days.

Results: A total of 91 patients were studied with men and women ratio of 3.55:1. Most common age group was the 4th decade with mean age being 36 years, while most common symptom was abdominal pain. X-ray abdomen erect showed gas under diaphragm in 75 (82.41%) patients and leukocytosis was present in 91.21% of cases. Duodenal perforations (n = 77, i.e., 84.62%) were more common than gastric perforations (n = 14, i.e., 15.38%). Simple closure with omental patch (n = 74, i.e., 81.32%) was the most common surgical method employed. Wound sepsis (n = 45, 49.4%) was the most common complication.

Conclusion: Perforation of peptic ulcer is one of the most common causes which require emergency laparotomy. Duodenum and pylorus are commonly involved and simple closure with omental patch was effective. Early operation is the key to successful treatment and minimizes mortality.

Key words: Perforated peptic ulcers, duodenal ulcer, gastric ulcer, perforation, clinical study

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American Journal of Diagnostic Imaging


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