A Study of Factors Influcing Prognosis in Perforated Peptic Ulcer

Abstract

Background: Aim: Peptic perforation is one of the commonest surgical emergencies met with but due to poor socioeconomic status, lack of health consciousness and want of diagnostic & treatment facilities at the peripheral healthcare level, they present considerably late most of the time. Our aim was to study the factors affecting prognosis. Methods: A prospective review was made in all charts of parameters between the period June 2014 to Dec 2016. After admission detailed history was elicited from the patient and a thorough clinical examination was done and the available investigations were done to approach at the diagnosis. Long term follows up was done & patients lost to follow up were excluded from the study. Results: Gas was present under one or both domes of the diaphragm in 76 (89.4%) cases. In rest 9 (10.6%) cases no free gas under diaphragm was see. In 77 cases (91.7%) perforation was present in the first part of duodenum (anterior or superior wall). 7 cases (8.3%) had perforation in the pyloric region. 25.7% cases had 1-5 mm size, 35.3% cases had 6-10 mm and 77 % cases had perforation more than 10 mm diameter respectively. Conclusion: Hence from the ongoing discussions it may be concluded that; a common surgical emergency called 'perforated peptic ulcer' is associated with a significant mortality. As the variables like age, perforation size and site, co-existent medical diseases are not changeable. It is early intervention that holds the key to lower the mortality of this otherwise fatal condition.