Title: Intraoperative Findings in Patients of Peptic Ulcer Perforation: A Prospective Study in Correlation with Patient Outcome
Authors: Dr Vinod Yedalwar, Dr Rajeev Kaneria, Dr Atul Kumar Singh, Dr Lalmani Singh
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.154
Abstract
Background: Peptic ulcer perforation is an emergency and requires prompt diagnosis and urgent surgical intervention. Overall, peptic ulcer mortality and hospitalization rates have declined for the past two decades, but complications such as peptic ulcer perforation and bleeding remain a substantial health-care problem.
Material and Methods: A prospective 1-year study conducted in 116 cases of peptic perforation admitted in surgical wards of Sanjay Gandhi Memorial Hospital, Rewa M.P. during the study period June 2016-May 2017.All patients suspected of peptic perforation were admitted to surgery ward and underwent emergency exploratory laparotomy. Post-operatively H. pylori serological test to detect IgG antibody was done with patients blood serum. Their findings were recorded in a proforma and master chart. The information obtained was tabulated and analyzed.
Results: Incidence of peptic perforation was 116 (1.20%) cases of all surgical admissions, Most common site of peptic perforation was anterior wall of first part of duodenum in 61 (55.4%) cases, omentopexy was most common procedure done i.e. in 106 (91.37%) cases, overall Mortality was 15 (12.93%) cases.
Conclusion: Perforated peptic ulcer is a disease of middle aged adults. Delay in hospitalization due to initial treatment by homemade medicines and non availability of essential surgical care further complicates the perforation in this region.
Perforation is diagnosed on clinical grounds immediately as patient reaches emergency department yet due to delayed hospitalization, time lost in resuscitation of the patient affects the outcome of standard surgical procedure. Selection of appropriate surgical procedure and postoperative care is helpful in early and uneventful recovery. Post operative H. pylori eradication therapy follow up endoscopic facilities in patients found positive for H. pylori can reduce recurrence rates and subsequently the burden of this disease.
Keywords: Peptic ulcer perforation, intraoperative findings, Outcome.
