International Journal of Medical and Health Research


ISSN: 2454-9142

Vol. 5, Issue 12 (2019)

Clinical assessment of prevalence of peptic ulcer perforation and its outcome in patients from Bihar region

Author(s): Dr. Nishi Kumari, Dr. NK Sinha
Abstract: When acute or chronic peptic ulcer perforates into the peritoneal cavity, three components require treatment viz., the ulcer, the perforation and the resultant peritonitis. The perforation and resultant peritonitis are immediate threats to the life; the ulcer in itself is not. The therapeutic priorities thus are treatment of peritonitis and securing the closure of perforation, which may be achieved with surgical procedure. In spite of better understanding of disease; effective resuscitation and prompt surgery under modern anaesthesia techniques, there is high morbidity and mortality. Hence, attempt has been made to analyze the various factors, which are affecting the morbidity/mortality of patients with peptic ulcer perforations. The present study was planned in Department of General Surgery, Nalanda Medical College, Patna. Total 25 cases diagnosed with the duodenal ulcer proliferation were enrolled in the present study. When acute or chronic duodenal ulcer perforates into the peritoneal cavity, three components require treatment viz., the ulcer, the perforation and the resultant peritonitis. The perforation and resultant peritonitis are immediate threats to the life; the ulcer in itself is not. The therapeutic priorities thus are treatment of peritonitis and securing the closure of perforation, which may be achieved with surgical procedure. In spite of better understanding of disease, effective resuscitation and prompt surgery under modern anaesthesia techniques, there is high morbidity and mortality. Hence, attempt has been made to analyze the various factors, which are affecting the morbidity/mortality of patients with peptic ulcer perforations. Peptic ulcer perforation is one of the most common acute abdominal emergencies. Early presentation holds a good prognosis. Unfortunately; in developing countries like India, patients usually present late to the hospital with full blown peritonitis, septic shock and multi organ failure. The outcome of the patient depends on the following factors:- age of the patient, associated co-morbidities, time interval between onset of acute abdominal pain and surgery, condition of the patient at the time of surgery like dehydration, contamination and septicaemia. The risk of mortality increases with increase in age, severe contamination of the abdomen observed during surgery leading to post-operative sepsis and increase in time interval between onset of acute pain and surgery. Prompt diagnosis, aggressive resuscitation, early surgery and the quickly performed simple Cellan Jones omental patch repair results in high survival in these moribund patients.
Pages: 19-23  |  293 Views  65 Downloads
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