Clinical Study on Patients with Duodenal Perforation

Clinical Study on Patients with Duodenal Perforation

  • S P Rajan Associate Professor, Department of General Surgery, P K DAS Institute of Medical Sciences,Vaniamkulam, Ottapalam, Kerala, India
  • Sudheer UK Assistant Professor, Department of General Surgery, P K DAS Institute of Medical Sciences, Vaniamkulam, Ottapalam, Kerala, India
  • Sreejith Assistant Professor, Department of General Surgery, P K DAS Institute of Medical Sciences, Vaniamkulam, Ottapalam, Kerala, India
  • Dinesh Babu M V Associate Professor, Department of General Surgery, P K DAS Institute of Medical Sciences,Vaniamkulam, Ottapalam, Kerala, India
Keywords: Serum CRP, Serum PCT, post operative Infection, Hepato-biliary surgery

Abstract

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.

Published
2020-05-26