A study of the cases of peptic perforation with reference of risk analysis and a prognostic grading scale

Abstract

Background: Perforation is the most serious, the most fatal and one of the commonest complication of all gastric and duodenal ulcers and occurs in about 10 to 15% of all recognized chronic peptic ulcers. Very low mortality and good results but it has not become popular till now. The objective was to correlate (Assess) the prognosis with "Grading scale" and to evaluate the factors affecting the prognosis and also to know the Incidence, Male/ Female sex ratio, and Social distribution. Methods: Study of 118 consecutive cases of peptic perforation, particularly dealing with their clinical manifestations and management. All cases were admitted in the Department of surgery of Hamidia Hospital Bhopal. The Permission from Institutional Ethics Committee was obtained. From each and every patient included in the study, initially informed individual consent was taken. Results: Average duration between onset of perforation and admission was: 38 hours 11 minutes. Average duration between admission and operation was: 7 hours 23 minutes. Average duration between onset of perforation and operation was: 45 hours 34 minutes. Conclusion: Benign ulcer perforations were most common in the age group of 30 -39 years and 40 -49 years. Close follow-up at interval of three months is recommended for every case of perforation treated by simple suture. In case of recurrence of ulcer symptoms failing to respond medical treatment, gastrojejunostomy and truncal vagotomy is recommended.