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Perforated peptic ulcer in the elderly

E Kane, G Fried, C K McSherry

Journal of the American Geriatrics Society

|May 1, 1981

Summary

This summary is machine-generated.

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Diagnosing perforated peptic ulcers in elderly patients is challenging due to minimal symptoms. Improved diagnostic methods like contrast imaging and endoscopy are crucial for timely intervention and reducing mortality in this vulnerable population.

Area of Science:

Gastroenterology
Geriatric Medicine
Surgical Gastroenterology

Background:

Perforated peptic ulcers present diagnostic challenges in elderly patients.
A study reviewed cases of perforated gastric or duodenal ulcers in patients over 60.

Observation:

Minimal symptoms and physical findings were common in this elderly cohort.
Abdominal roentgenograms detected free intraperitoneal air in only 60% of cases.
Diagnosis was confirmed post-mortem in 3 patients.

Findings:

Surgical intervention included plication (28 patients) or hemigastrectomy-vagotomy (1 patient).
Postoperative morbidity was high at 62%, with a 17% mortality rate.
Delayed or missed diagnosis significantly contributed to mortality.

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Implications:

Accurate diagnosis is critical for improving outcomes in elderly patients with perforated peptic ulcers.
Increased utilization of contrast roentgenograms and endoscopy is recommended.
Enhanced diagnostic strategies can reduce mortality in this demographic.