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Perforated peptic ulcer.

P H Jordan1, C Morrow

  • 1Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas.

The Surgical Clinics of North America
|April 1, 1988
PubMed
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Peptic ulcer disease is declining, but perforated and bleeding ulcers remain a concern, especially in older adults. Surgical intervention, particularly simple closure for high-risk patients, is recommended for perforated ulcers.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology

Background:

  • Peptic ulcer disease incidence has decreased since 1950 in industrialized countries.
  • Perforated and bleeding ulcer rates remain stable or slightly decreased, with a notable increase in elderly patients.
  • Operative management is favored over non-operative treatment for perforated ulcers.

Purpose of the Study:

  • To review the current trends and management strategies for peptic ulcer disease, focusing on perforated and bleeding ulcers.
  • To discuss the preferred operative choices for perforated peptic ulcers.

Main Methods:

  • Literature review of peptic ulcer disease trends and surgical outcomes.
  • Analysis of management options for perforated peptic ulcers, including simple closure and definitive surgery.

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Main Results:

  • While overall peptic ulcer disease has declined, perforated and bleeding ulcers persist, particularly in the elderly population.
  • Simple closure is recommended for patients with significant risk factors undergoing surgery for perforated ulcers.

Conclusions:

  • Surgical management is the preferred approach for perforated peptic ulcers.
  • Simple closure is a suitable option for high-risk individuals.
  • Parietal cell vagotomy combined with ulcer closure is the author's preferred definitive surgical treatment when feasible.