Perforated Peptic Ulcer Disease in a Tertiary Hospital, Addis Ababa, Ethiopia: Five Year Retrospective Study

Abstract

BACKGROUND: Peptic ulcer perforation is one of the two major acute complications of peptic ulcer disease with significant morbidity and mortality.METHODS: Institution based retrospective review was done to determine patient presentation, management and postoperative complications of perforated peptic ulcer disease (PPUD) at a tertiary hospital in Addis Ababa, Ethiopia. Patients operated on from January 2013 to December 2017 were included. Univalent analysis was used to determine the influence of patient and operative events on postoperative outcomes.RESULT: Totally, 136 patients were studied. Males outnumbered females by a ratio of 5.5:1. The mean age of patients was 36.05±16.56 years. Seventy-one (52.2%) patients presented after twenty-four hours of onset of symptoms. Most perforations were located on the first part of the duodenum (117,86%). There were 73 postoperative complications recorded in 31(22.8%) patients. Old age, being female, presence of comorbidity, hypotension, tachycardia, and delayed presentation were significantly associated with postoperative morbidity (P<0.05). Nine (6.6%) patients died at the hospital. Mortality was significantly associated with old age, comorbid illness, tachycardia, and development of post-operative complications (P<0.05). The postoperative hospital stay of the patients with complications was 18.6 ± 14.7 days which was significantly higher than that of patients without complication 6.7±2.7days (P=0.001).CONCLUSION: Old age, being female, presence of comorbidity, hypotension, tachycardia, and delayed presentation were significantly associated with postoperative morbidity. Old age, comorbid illness, tachycardia and development of post-operative complications were found to increase the risk of mortality.

Perioperative Outcome and its Determinants among Patients with Perforated Peptic Ulcer Disease in Debre Berhan Comprehensive Specialized Hospital: Three Years Retrospective Cross-Sectional Study

“…The study has revealed that there is a high male predominance in having perforated peptic ulcer disease (3.7:1), which is consistent with several other studies conducted in Africa (5,8,20) but in contrary to Western setups, where it is a disease of elderly women with comorbidities (9).…”

“…Graham's omental patch of the perforations with either a pedicled omental patch or a free graft of omentum was the procedure performed for the majority of patients in this study. The mortality rate in this study was found to be 4.25% which is comparable with a study conducted in central Ethiopia 6.6% (20), but lower than the ndings of several other studies done in Tanzania (10.7%), Black Lion Hospital (BLH), Ethiopia (19%) and India (14%) (3,8,14). Relatively younger patients and a lower prevalence of comorbid illness in this study can explain this nding of a lower mortality rate.…”

COVID-19 related stress and the risk of perforated peptic ulcer: a cross-sectional study

“…In this study, we found that before the pandemic, PPU were predominantly male. Previous research before the pandemic period has also shown males were more at risk of developing a complicated peptic ulcer, especially in a developing country [11,12] . During the pandemic, PPU were predominantly female.…”

Management Outcome and Associated Factors of Perforated Peptic Ulcer Disease at Yekatit 12 Hospital Medical College and Tirunesh Beijing Hospital

“…The clinical picture may be less clear in the obese, the immunocompromised, patients on steroids, patients with a reduced level of consciousness, the elderly, and children. In these situations, the clinical history and examination may be non-specific prompting additional imaging and laboratory studies to rule out differential diagnoses' The presence of gas under the diaphragm on plain abdominal erect X-ray is diagnostic in 75% of the cases [4,6,7].…”