Generalized peritonitis requiring re-operation after leakage of omental patch repair of perforated peptic ulcer

Abstract

Background/Aim:Peptic ulcer perforations are a common emergency, but available literature is silent on the exact definition, incidence, management, and complications of peritonitis due to omental patch leakage.Patients and Methods:Retrospective data were collected on 422 patients who underwent omental patch repair of perforated peptic ulcer between March 20, 1999 and March 20, 2006. The definitive diagnosis of perforated peptic ulcer and omental patch leakage was obtained at surgery.Results:Seventeen (4%) patients experienced generalized peritonitis due to omental patch leakage. Mean age was 60.6 years. Mortality rate was 29.4%, and the mean hospital stay was 23.6 days. Delay in surgical approach, shock on admission, and age were all significantly associated with increased mortality.Conclusions:Peritonitis due to omental patch leakage can result in significant morbidity and mortality. The most common causes of omental patch leakage and operative procedures were unknown and reinsertion of omentum, respectively. Factors such as shock on admission or delayed surgery, have significantly contributed to fatal outcomes and need careful attention.

Comparison of operative procedures for re-leaks duodenal perforation: a cross-sectional analysis from a tertiary care hospital in a developing country

“…13 Poor level of success was also found in the present study contrasting with the results of Maghsoudiet al where the authors obtained a success of arresting the re-leak in 13/17 patients. 11 Similarly, we found higher mortality in contrast to Wakayama et al wherein the authors found a mortality of only 5%.…”

Spectrum of Presentation and Management of External Duodenal Fistula Following Surgery- A Hospital Based Study

“…Hamby et al described a simple apposition procedure for arresting the re-leak but inflammation and induration of the ulcer surroundings precludes this intervention [6] . Poor level of success of surgical intervention was found in our study which is in contrast with the results of Maghsoudi et al where the authors obtained a success of arresting the re-leak in 13/17 (76.5%) patients [7] .…”

Strategies to improve the outcome of emergency surgery for perforated peptic ulcer

“…Postoperative complications are frequent, and include common diagnoses such as wound and other abdominal infections, thromboembolic events and organ failure. Rarer complications include omental patch leakage requiring reoperation in about 4 per cent of patients and persistent duodenal fistula.…”