Perforated Peptic Ulcer in Lagos. Risk Factors and Management Outcome

Area of Science:

• Gastroenterology
• Surgical Emergencies
• Public Health

Background:

• Perforated peptic ulcer (PPU) is a life-threatening surgical emergency causing peritonitis, with significant morbidity and mortality.
• Outcomes of PPU surgery vary globally; documented series from Nigeria are scarce.
• This study reviews the management and outcomes of PPU at a Nigerian institution.

Purpose of the Study:

• To review the management and outcomes of perforated peptic ulcer (PPU) in Nigerian patients.
• To identify risk factors, common ulcer types, and complications associated with PPU.
• To contribute to the limited documented data on PPU in Nigeria.

Main Methods:

• Retrospective review of medical records for PPU patients from February 2008 to February 2023.
• All patients underwent surgical repair of a single anterior peptic ulcer perforation using a modified Graham's patch.
• Data analysis was performed using IBM SPSS Version 23.

Main Results:

• 107 PPU patients (93 males, 14 females; mean age 41) were analyzed, with peak prevalence in the 30-39 age group.
• Delayed presentation occurred in approximately half of the patients; NSAID ingestion was the most common risk factor.
• Perforated gastric ulcers (71%) were more common than duodenal ulcers (22%); large ulcer size (10-30 mm) was frequent but not linked to complications or mortality.
• Surgical site infection was the most common complication, followed by systemic sepsis and superficial wound infection. Median hospital stay was 13 days.

Conclusions:

• PPU in this cohort predominantly affected males in their fourth decade, with NSAID use as a major risk factor.
• Gastric ulcers were more common than duodenal ulcers, and large perforations were frequently observed.
• Key complications included surgical site infection, systemic sepsis, and superficial wound infection.