DOI: http://dx.doi.org/10.18203/2349-2902.isj20195214

A clinical study of factors affecting the prognosis in duodenal ulcer perforation cases in tertiary care hospital, Kanchipuram district

Dhinesh Babu K., M. Bhaskar

Abstract


Background: Peptic ulcer disease is an erosion of the lining of the stomach or duodenum. It is associated with potentially life-threatening complications such as bleeding, perforation and obstruction. The main predisposing factors for peptic ulcer perforation are smoking, use of non-steroidal anti-inflammatory drugs (NSAIDs), chronic stress, Helicobacter pylori infection, and age >60 years. In recent years, with introduction of proton pump inhibitors and increased knowledge of duodenal ulcer perforation (DUP) has decreased the incidence of DUP.

Methods: 50 patients with DUP were studied prospectively with respect to age, gender, use of NSAIDs, morbidity, mortality and complications.

Results: Out of 50 patients, the mean age of incidence DUP was 46 yrs, which is more common in males. And also 48% patients were chronic alcoholic and 52% patients were chronic smokers. Moreover, 14% patients were chronic NSAIDs users.

Conclusions: Factors such as age, gender, use of NSAID, Alcohol and smoking affects the life expectancy of the patients, which leads to morbidity and mortality.


Keywords


Duodenal ulcer perforation, Peptic ulcer disease, NSAIDs

Full Text:

PDF

References


Lenepneau I. Cas de perforation der duodenum de lien d’une ancienne cicatrice de cet intestina. Gaz Hop. 1839;35:137.

Milosavljevic T, Kosti´c-Milosavljevi´c M, Jovanovi´c I, Krsti´c M. Complications of pepticulcer disease. Dig Dis. 2011;29(5):491-3.

Gunshefski L, Flancbaum L, Brolin RE, Frankel A. Changing patterns in perforated pepticulcer disease. Am Surg. 1990;56(4):270-4.

Sung JJ, Kuipers EJ, El-Serag HB. Systematic review: the global incidence and prevalence of peptic ulcer disease. Aliment Pharmacol Ther. 2009;29:938-46.

Lassen A, Hallas J, Schaffalitzky de Muckadell OB. Complicated and uncomplicatedpeptic ulcers in a Danish county 1993-2002: a population-based cohort study. Am J Gastroenterol. 2006;101(5):945-53.

Svanes C. Trends in perforated peptic ulcer: incidence, etiology, treatment, and prognosis. World J Surg. 2000;24(3):277-83.

Dean HP. A case of perforation of a chronic ulcer of the duodenum successfully treated by excision: death two months later from acute intestinal obstruction by a band. Br Med J. 1894;1:1014-5.

Cellan-Jones CJ. A rapid method of treatment in perforated duodenal ulcer. Br Med J. 1929;1:1076-7.

Graham RR. The treatment of perforated duodenal ulcers. Surg Gynecol Obstet. 1937;64:235-8.

Mouret P, Francois Y, Vignal J, Barth X, Lombard-Platet R. Laparoscopic treatment of perforated peptic ulcer. Br J Surg. 1990;77:1006.

Bae S, Shim KN, Kim N, Kang JM, Kim DS, Kim KM, et al. Incidence and short-term mortality from perforated peptic ulcer in Korea: a population-based study. J Epidemiol. 2012;22(6):508-16.

Chalya PL, Mabula JB, Koy M, McHembe MD, Jaka HM, Kabangila R, et al. Clinical profile and outcome of surgical treatment of perforated peptic ulcers in Northwestern Tanzania: a tertiary hospital experience. World J Emerg Surg. 2011;6:31.

Guti´errez de la Pe˜na C, Ma´rquez R, Fakih F, Dom´ınguez- Adame E, Medina J. Simple closure or vagotomy and pyloroplasty for the treatment of a perforated duodenal ulcer: comparison of results. Dig Surg. 2000;17(3):225-8.

Rahman MM, Islam MS, Flora S, Akhter SF, Hossain S, Karim F. Mortality in perforated peptic ulcer patients after selective management of stratified poor risk cases. World J Surg. 2007;31(12):2341-4.

Cheng M, Li WH, Cheung MT. Early outcome after emergency gastrectomy for complicated peptic ulcer disease. Hong Kong Med J. 2012;18(4):291-8.

Lohsiriwat V, Prapasrivorakul S, Lohsiriwat D. Perforated peptic ulcer: clinical presentation, surgical outcomes, and the accuracy of the Boey scoring system in predicting postoperative morbidity and mortality. World J Surg. 2009;33(1):80-5.

Stepanyan SA, Petrosyan AA, Safaryan HH, Yeghiazaryan HH, Aleksanyan AY, Hakobyan VM, et al. Laparoscopic and open repair for perforated duodenal ulcer: single-center experience. Videosurgery and Other Miniinvasive Techniques. 2019;14(1):60.

Behrman SW. Management of complicated peptic ulcer disease. Arch Surg. 2005;140:201-8.

Noola GS, Shivakumar CR. A clinical study of duodenal ulcer perforation. Int Surg J. 2016;3:711-3.

Kocer B, Surmeli S, Solak C, Unal B, Bozkurt B, Yildirim O, et al. Factors affecting mortality and morbidity in patients with peptic ulcer perforation. J Gastroenterol Hepatol. 2007;22(4):565-70.

Agarwal A, Jain S, Meena LN, Jain SA, Agarwal L. Validation of Boey’s score in predicting morbidity and mortality in peptic perforation peritonitis in Northwestern India. Trop Gastroenterol. 2015;36(4):256-60.

Taylor H. Perforated peptic ulcer treated without operation. Lancet. 1946;2:441-4.

Ansari D, Torén W, Lindberg S, Pyrhönen HS, Andersson R. Diagnosis and management of duodenal perforations: a narrative review. Scandinavian J Gastroenterol. 2019;54(8):939-44.