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Management of perforated peptic ulcer in patients at a teaching hospital
Ali K Bin-Taleb1, Riyadh A Razzaq, Zaki O Al-Kathiri
1Department of Surgery, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen.
Insights
Management of perforated peptic ulcers (PPU) predominantly affects younger adults. Timely surgical intervention and improved post-operative care are crucial for reducing complications and improving outcomes in PPU patients.
Area of Science:
- Gastroenterology
- Surgical Management
- Public Health
Background:
- Perforated peptic ulcer (PPU) is a serious surgical emergency.
- Optimal management strategies for PPU require continuous evaluation.
Purpose of the Study:
- To analyze the current management practices for patients diagnosed with perforated peptic ulcers.
- To identify key factors influencing patient outcomes in PPU cases.
Main Methods:
- Retrospective study conducted at Al-Gamhouria Teaching Hospital, Aden, Yemen.
- Inclusion criteria: patients admitted with perforated benign peptic ulcers between January 1997 and December 2006.
- Data analysis of patient demographics, presentation time, surgical intervention, complications, and outcomes.
Main Results:
- 156 patients (88.5% male) with a mean age of 39.08 years were studied.
- PPU was most frequent in the 21-40 age group (58.3%).
- Simple perforation closure was the primary surgical method (91.7%); 41% experienced postoperative complications, with wound sepsis being most common (55.2%).
- Mortality rate was 3.9% (6 deaths).
Conclusions:
- Younger adults (21-40 years) are disproportionately affected by PPU.
- Reducing time to surgery is critical for better patient outcomes.
- Simple closure is effective, but improving surgical skills, wound care, and hospital resources is essential to lower complication rates.
Objective:
To explore and analyze the current status in management of patients with perforated peptic ulcers (PPU).
Methods:
A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study.
Results:
A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU was noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.38:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours), wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks.
Conclusion:
Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment, and equipment are needed to reduce the high rate of complications.
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