Perforated peptic ulcer

Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M; Bingener, Juliane; Møller, Morten Hylander; Ohene-Yeboah, Michael; Søreide, Jon Arne

doi:10.1016/s0140-6736(15)00276-7

Cited by 310 publications

(317 citation statements)

References 91 publications

(95 reference statements)

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“…Adherence to peri-operative sepsis protocol is most important to reduce mortality. 8 There was an overwhelming preponderance of males in this study. This is similar to the observations of many other reports of PPU in which almost 80% are males.…”

Section: Discussionmentioning

confidence: 59%

“…Dimension, the size did not correlate with mortality Post-operative morbidity following repair of PPU is high and ranges from 17-63%. 8,26 The most common complication seen in our study is surgical site infection. Wound related problems are also the leading concern reported by other authors.…”

Section: Discussionmentioning

confidence: 63%

“…6 Perforation is the most common complication of peptic ulcer and also the most lethal with mortality rates upto 30%. 7,8 Although outcomes from bleeding ulcers have improved with the availability of modern endoscopic techniques, the outcomes of PPU have still remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

“…8 The most frequently used scores are the American Society of Anesthesiologists (ASA) physical status classification system, the Boey score, the peptic ulcer perforation (PULP) score and POMPP score. The last three scores are designed specifically for the prediction of mortality for PPU patients and consider relatively simple data obtained pre-operatively.…”

Section: Discussionmentioning

confidence: 99%

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The outcome of surgery for perforated peptic ulcer in modern times

Vats¹,

Rehmani²,

Agrawal³

2018

Int Surg J

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Background: A laparotomy for peritonitis due to perforated peptic ulcer is one of the commonest emergency operations done by a general surgeon and is still associated with a marked mortality and morbidity. The aim was to assess the current mortality and morbidity in patients operated for perforated peptic ulcer and to identify the factors associated with increased mortality in these patients.Methods: All adult patients operated for perforated peptic ulcer over a period of one year were included in this prospective observational study. The demographics, clinical presentation, pre-operative laboratory parameters, operative findings, operation done, and the outcomes were noted in pre-designed proforma. Mortality and morbidity was assessed and factors relating to increased mortality were determined using standard statistical tests of significance such as Chi square test and the student’s t test.Results: 55 patients underwent laparotomy for perforated peptic ulcer (23 gastric and 32 duodenal perforations). There were 53 males and only 2 females in the group. Their mean age was 44 years. The mortality was 16% (9/55) and morbidity was 25% (14/55). Complications were encountered in 14 patients, most commonly surgical site infection in 13% cases, entero-cutaneous fistula occurred in 3 patients and one of them expired despite re-exploration due to persistent sepsis. The other two patients survived, and fistula healed spontaneously. The operative procedure done was Graham’s patch or it’s modification. Only 2 patients had antrectomy with Billroth II reconstruction.Conclusions: Despite the advances in management of critically ill patients, the mortality (16%) and morbidity (25%) for this common surgical emergency remains high and is unchanged over the last half century. Presence of comorbidities and low serum albumin are associated with an increased risk of adverse outcome.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The outcome of surgery for perforated peptic ulcer in modern times

Vats¹,

Rehmani²,

Agrawal³

2018

Int Surg J

View full text Add to dashboard Cite

show abstract

“…5,6 Early surgical repair and proper sepsis management are essential for good outcome. In this study 77.27% patients had no previous history of PUD and came with acute peritonitis due to peptic ulcer perforation.…”

Section: Discussionmentioning

confidence: 99%