Dr. B. Nagendar, Dr. Earjala Joel Kumar


AIMS AND OBJECTIVES : To determine the age & sex incidence in peptic ulcer perforation patients. To determine the
incidence of perioperative complications. To analyse the effect of time of presentation on morbidity and mortality in
patients with peptic ulcer perforation. To analyse various factors effecting the morbidity and mortality in patients with peptic ulcer perforation
MATERIAL AND METHODS : This is a 1 year prospective study which includes 50 cases, i.e., from august 2016 to November 2017 at
Osmania General Hospital, Osmania Medical College, Hyderabad. All the 50 cases were admitted in Osmania General Hospital diagnosed with
gastric & duodenal ulcer perforation were included in the study. All the cases admitted in Osmania General Hospital diagnosed with gastric ulcer
RESULTS : Peptic ulcer perforation was common in males than females in ratio of 15.6:1. Morbidity rate in our study is 70% and mortality rate
16%. Peptic ulcer perforation was common in the age group of 30-50 years with mean age 44.2 years. Elderly patients (≥ 65 years) had increased
mortality. Smoking had less significant effect in postoperative morbidity and mortality whereas alcohol consumption slightly increased
morbidity as well as mortality. Previous history of peptic ulcer disease was not an important risk factor in causation peptic ulcer perforation, as
sizeable number of patients did not give positive history of dyspepsia or peptic ulcer symptoms. It was also not a significant risk factor in
postoperative mortality and morbidity. Associated co- morbid conditions increased postoperative mortality and morbidity. Shock on admission
was a determinant of morbidity and mortality in peptic ulcer perforation. In this study shock on admission was a risk factor for morbidity in
peptic ulcer perforation. 5 of 7 patients with pre-operative shock died. Among 17 patients who underwent surgery ,24 hours after the onset of
symptoms, 15 (30%) developed morbidity and 5 (10%) suffered morbidity. So delayed surgery (> 24 hours) is associated with increased
morbidity and mortality in postoperative period. There were 5 patients with Hb<11. Out of them 3(6%) developed morbidity and 1(2%) died.
Duodenal perforation was associated with increased mortality (30%) as compared to gastric perforation (20%).
CONCLUSION : Among 50 patients, most common postoperative complication was death in about 8(16%) patients followed by pulmonary
complications, renal failure and sepsis. Risk factors for morbidity and mortality in perforated peptic ulcer were age 65 years, associated medical
illness, alcohol consumption, duration of perforation more than 24 hours before surgery and presence of shock on admission.


Gastric Ulcer, Duodenal Ulcer, Peptic Ulcer Perforation, Shock, Morbidity, Mortality.

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