An autopsy survey of peptic ulcer disease at Ibadan

The frequency of peptic ulcer disease remains highly controversial worldwide and from this environment there is little information either on the mortality and the factors contributory to death from the disease or on the associated conditions in patients with asymptomatic ulcers. The purpose of this study was to focus on these issues in an autopsy population at the University College Hospital, Ibadan, Nigeria. The overall incidence of peptic ulcer disease was 5 percent and the disease was a direct cause of death in 1.5 percent of the autopsy population. Bleeding was the most frequent cause of death from peptic ulcer disease and was responsible for 72.2 percent of the deaths due directly to ulcer disease. This was followed by ulcer perforation found in 25.9 percent of the deaths. The factors contributing to mortality include non-compliance with treatment and delay in presentation at the hospital. Correlations have been demonstrated in all age groups between asymptomatic peptic lesions and severe pathological conditions such as typhoid septicaemia. The relevance of this later finding is briefly discussed.