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Septic complications of perforated peptic ulcer

I W Fong

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |July 1, 1983
    PubMed

    Insights

    Septic complications following peptic ulcer perforation are a significant risk, especially with delayed treatment. Early surgical intervention and routine peritoneal fluid cultures are crucial for managing intra-abdominal sepsis.

    Area of Science:

    • Gastroenterology
    • Surgical Infections

    Background:

    • Peptic ulcer perforation is often associated with minimal septic risk due to sparse upper GI microflora.
    • Limited literature adequately describes the septic complications of peptic ulcer perforation.

    Purpose of the Study:

    • To review the incidence and types of septic complications following peptic ulcer perforation.
    • To identify risk factors associated with postoperative sepsis in these patients.

    Main Methods:

    • Retrospective review of 182 peptic ulcer perforations (150 duodenal, 32 gastric) over 15 years.
    • Analysis of septic complications including intra-abdominal abscess, wound infection, and generalized peritonitis.

    Main Results:

    • Septic complications included intra-abdominal abscess (22), wound infection (26), and peritonitis (18).
    • Higher incidence of postoperative abscesses in gastric (32) versus duodenal (150) perforations (p<0.05).
    • Abscesses were more frequent when perforation occurred >24 hours before surgery.

    Conclusions:

    • Acute peptic ulcer perforation carries a substantial risk of intra-abdominal sepsis.
    • Routine anaerobic and aerobic cultures of peritoneal fluid during operation are recommended.

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