INTRODUCTIONPerforative peritonitis is one of the commonest surgical emergencies faced by surgeons all over India. 1,2 Of these peptic ulcer perforation is the commonest cause of peritonitis.3 These perforations are usually encountered in the first part of the duodenum anteriorly and in the pylorus of stomach. The occurrence of perforative peritonitis is associated with previous history of peptic ulceration in only few patients.The workup of peptic ulcer perforation includes x-ray abdomen, ultrasound, basic laboratory investigations and special investigation for Helicobacter pylori in places where facility is available. The role of contrast enhanced CTSCAN exists only in areas where diagnosis is doubtful. The only rational treatment of perforated peptic ulcer is surgical operation. The role of conservative treatment is in only sealed perforations with little contaminated fluid in the abdominal cavity with resolving pneumoperitoneum and hemodynamically stable patient. Simple closure of the perforation with non-absorbable suture material and graham's omentopexy using tongue of greater omentum are the procedures of choice. Vagotomy and highly selective vagotomy are the definitive procedures of choice; seldom attempted in emergency setting. Local bilateral flank drain placement is done in cases not fit for anesthesia and provides an interim management by drainage of the infected fluid ABSTRACT Background: Peptic ulcer perforation is the commonest surgical emergencies in India. Recent emergency surgical procedures show an increasing trend in peptic ulcer perforation surgery in young adults. This study is carried out with an aim to understand the trend, causation and complications of peptic ulcer perforation in young Indians. Methods: A prospective observational study of young adult Indian patients operated for emergency peptic ulcer perforation for a 3 years period from January 2014 to January 2017 was carried out. The incidence, causative factors and the complications were analyzed. Results: In study of 150 patients, maximum incidence of 42.85% was seen in age group of 21 to 30 years that is young adults. 80% of them were males. 59% patients had blood group O. Association with smoking and alcoholism was seen in about 64% and 66.6% respectively. In about 13.33% there was an association seen with history of NSAID / steroid ingestion / treatment with proton pump inhibitors or H2antagonists.The duodenal perforation was found in 84.66%. In 90% the perforation was less than 1cm.Wound infection was the commonest complication among all patients. Mortality was seen in 3.33%. Conclusions: Peptic ulcer perforation shows increasing incidence in young adult males. The increased incidence shows association to smoking, alcoholism, irregular food habits, use of NSAIDS/steroids and overall stressed lifestyle.
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