Peptic perforation: epidemiology, etiology and management at tertiary care hospital in Gujarat

Abstract

Objectives: The aims and objectives of the present study are as follows: (1) to assess value of clinical features and radiological investigations in cases of perforated peptic perforation (2) to study the relationship between tobacco, alcohol consumption and perforated peptic ulcer (3) to study the different operative methods (4) to study the histopathological diagnosis of ulcer margin (5) to study the mortality and post-operative complications (6) to assess complains in follow-up and study endoscopic findings. Methods: This was the prospective study consist of 50 cases of peptic perforation studied at general hospital during the period of 2003 to 2005. Results: 60% of patients were in age group of 21-50 years. 40% of patients were tobacco chewer. Abdominal pain was the commonest symptom of all patients. The surgical treatment in form of simple closure with omentopexy gives excellent results. Discussion: In this study the highest no of patients were in 5th decade of life. Male female ratio indicated male preponderance but decrease in the ratio as compare to previous study. Still plain x ray abdomen is the gold standard investigation in diagnosis. With better anaesthesia, higher antibiotics, and aggressive chest physiotherapy post-operative complications were reduced. Conclusion: The increasing incidence in female may be due to increasing tendency for women to take on the responsibilities and occupations traditionally associated with men. Perforation closure with omentopexy gives excellent result. Post operatively anti H pylori treatment will help to prevent recurrence.