Early Complications of Suture Closure of Perforated Duodenal Ulcer: A Study of 100 Cases

Hannan, Abma; Islam, Md Baharul; Hussain, Muhammad; Haque, MM; Kudrat-E-Khuda, MI

doi:10.3329/taj.v18i2.3192

Cited by 8 publications

(7 citation statements)

References 3 publications

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“…The review of literature reports increased incidence of peptic ulcer perforation in the age groups 21-30 years as seen in the results reported by Elnagib E et al and Chaliya PL et al (41%) while other studies reported a maximum incidence in the age groups of 31 to 40 years as seen in studies by Bharti RC et al (48%)and Hannan A (34%). [6][7][8][9] Present study reports an incidence of 42.85% in the 21 to 30 years of age group which suggests predisposition of the disease in the younger adults.…”

Section: Discussionmentioning

confidence: 83%

Peptic ulcer perforation in young Indians the causation and the trend

Sabhnani¹,

Sindhu²

2017

Int Surg J

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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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Section: Discussionmentioning

confidence: 83%

Peptic ulcer perforation in young Indians the causation and the trend

Sabhnani¹,

Sindhu²

2017

Int Surg J

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“…Hannan et al 2 in 2005, in their study of peptic perforation, reported that the mean age was 41 years, the highest incidence 34% was in the age group of 30-40 years.…”

Section: Discussionmentioning

confidence: 97%

Study of incidence of peptic ulcer perforation in young adults

Bansod

Galande

et al. 2014

Int Surg J

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Background: Peptic ulcer perforation is the commonest perforation of the gastrointestinal tract affecting 2-10% population showing a shift from older to the younger population. With this statistics a study for incidence of peptic ulcer perforation in young adults 18-30 years was carried out. Methods: Prospective study of patients admitted on emergency basis and diagnosed as peptic ulcer perforation either gastric or duodenal perforation intraoperatively in patients 18-30 years were studied from June 2009 to October 2011. Results: Of 175 patients, 70 (40%) patients were between 18 and 30 years age. 58 (82.85%) were males and 12 (17.14%) were females. Twenty-three (32.85%) patients had history suggestive of acute peptic disease/ulcer and had taken some treatment in the form of antacid H-2 blocker or proton pump inhibitor while 47 (67.14%) patients had no history. Pain was the consistent symptom while tachycardia, tenderness, and guarding were the signs present in all 70 (40%) patients. Gas under diaphragm (pneumoperitoneum) was found in 67 (95.71%). Ultrasonography abdomen S/O pyoperitoneum was found that all 70 (100%). 57 (81.42%) patients had an anterior duodenal perforation, 12 (17.14%) patients had a gastric perforation with a ratio of 4.7:1, and 1 patient had a combined gastric and duodenal perforation. 1 (2.43%) patient expired in the post-operative period, 55 (78.57%) patients come for regular follow and 14 (20%) patients were lost to follow-up. Only 4 (7.2%) patients had mild to moderate symptoms of peptic ulcer disease which were controlled by anti-ulcer drugs. Conclusion: Peptic ulcer perforation is a disease more common in the young population with a male preponderance.

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“…Smitha S Sharma et al (2006), [5] in the study of peptic ulcer perforation found an association of smoking and peptic ulcer perforation in 28 percent of patients, while 72 percent of patients were nonsmokers. ABMA Hannan et al, [7] showed that 13 percent of patients had NSAIDS used, whereas 87 percent were not taking NSAIDS. Phillipo L Chalya et al, [8] in their study of peptic ulcer perforation, 64 percent of patients were smokers and 36 percent were nonsmokers.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Patients with Duodenal Perforation

Rajan

Sreejith

et al. 2020

AJS

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Background: Perforations of peptic ulcer are third in frequencies, acute appendicitis and acute intestinal obstruction being more common. Prompt recognition of the condition is very important and only by early diagnosis and treatment it is possible to reduce the still relatively high mortality. The aim of this study was to review and study the factors influencing, the outcome of the duodenal perforations. Subjects and Methods: A clinical study was conducted in 50 cases of diagnosed duodenal ulcer perforation that was established by the admitting surgeon, based on clinical features and supposed by radiological evidence and confined at operation. This study comprises of 50 cases of duodenal ulcer perforation admitted in period from January 2017 to January 2020. Results: In present study, out of total 50 patients with duodenal ulcer 46(92%) males and 5(8%) females, with male predominance. Highest incidence was found between 41-50 years followed by 21-29 years. Most of the patients admitted by 12-24 hours, common site of ulcer is prepyloric in presentation. Duodenal ulcer perforations were single perforation, while two cases of ileal perforations were multiple. Smoking is main predisposing cause of ulcer. ARDS were 14% (7 patients) and it was observed that 32 percent (16 patients) having wound complication, 2 percent (‘1 patient) having mortality and 46% (23 patients) have no complications. In this present study, 60% of patients had h/o Peptic ulcer. On X- ray, 90% of patients had finding of air under diaphragm. Conclusion: The mortality in perforated duodenal ulcer has been reduced owing to early approach to hospital, diagnosis, prompt surgical treatment and appropriate and adequate antibiotics. Smoking and alcohol consumption and life style modification may reduce morbidity and mortality in patients with duodenal perforation.

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Early Complications of Suture Closure of Perforated Duodenal Ulcer: A Study of 100 Cases

Cited by 8 publications

References 3 publications

Peptic ulcer perforation in young Indians the causation and the trend

Peptic ulcer perforation in young Indians the causation and the trend

Study of incidence of peptic ulcer perforation in young adults

Clinical Study on Patients with Duodenal Perforation

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