Simple closure of perforated duodenal ulcer

A study was undertaken to evaluate the efficacy of simple closure followed by drug therapy in cases of perforated duodenal ulcer and to identify the risk factors in relation to the mortality. The male to female ratio was 5:1. Of the patients 59.2% were up to 50 years of age, while 40.8% were above the age of 50 years. Of the patients 47% were admitted 24 hours after the onset of peritonitis. All these patients were surgically treated with simple closure of the perforation with omental patch. Nine patients expired leading to 7.5% mortality. The risk factors identified for mortality were age 60 years and above, presence of shock on admission and delayed presentation. The mortality is directly related to the number of risk factors present in a given patient. At the time of discharge the patients were advised to take orally famotidine 40 mg at bed time for a period of 8 weeks. Eighty-one patients could be followed up and Visick grading was done. Sixty-two patients were in grade I, 11 in grade II, 3 in grade III and 5 in grade IV. The results indicate that simple closure followed by drug therapy is acceptable treatment for perforated duodenal ulcer.