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Gastro-duodenal peptic ulcer perforation.
J C B Dakubo1, S B Naaeder, J N Clegg-Lamptey
1University of Ghana, Medical School, P.O. Box 4236, Accra, Ghana.
East African Medical Journal
|August 26, 2009
Summary
Perforated peptic ulcer disease is a growing cause of acute abdomen, frequently affecting younger individuals. Key predictors of poor outcomes include advanced age, delayed treatment, alcohol consumption, and resectional surgery.
Area of Science:
- Gastroenterology
- Surgical Epidemiology
- Public Health
Background:
- Perforated peptic ulcer disease (PPUD) presents a significant surgical emergency.
- Understanding its epidemiology and risk factors for morbidity and mortality is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the epidemiology of perforated peptic ulcer disease.
- To identify factors influencing morbidity and mortality after emergency surgery for PPUD in Accra, Ghana.
Main Methods:
- A retrospective and prospective hospital-based study was conducted at Korle-Bu Teaching Hospital.
- Data collected included patient demographics, clinical parameters, perforation site, surgical approach, and outcomes.
- Logistic regression analysis was used to identify significant predictors of complications and mortality.
Main Results:
- The incidence of PPUD increased significantly between 1998 and 2002, stabilizing at 5%.
- Commonly observed factors included duodenal perforations (88%), delayed presentation (>24 hours) in 46.2% of cases, and high rates of ulcerogenic substance intake (67%).
- Overall complication and mortality rates were 19% and 11%, respectively. Advanced age, delayed presentation, alcohol intake, and resectional surgery were significant predictors of adverse outcomes.
Conclusions:
- Perforated peptic ulcer disease is an emerging and frequent cause of acute abdomen, particularly in younger populations.
- Factors such as age over 60, delayed presentation (>24 hours), alcohol consumption, and undergoing resectional surgery are significant predictors of post-operative morbidity and mortality.
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Clinical Manifestations:
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