[Treatment of perforated duodenal ulcer. Reflections concerning 110 cases. (author's transl)]

Based on the analysis of 110 perforated duodenal ulcers, and the revue of the literature, the authors present the following comments: 1) The mortality in the acute phase depends mainly on the general condition of the patient; that is the reason why the Taylor's method, which is the least aggressive, is indicated in the debilitated patients, but only if it proves quickly its efficiency. In all the other cases, this method is not suitable because of its numerous early and late failures. 2) The immediate and late results of the simple suture of the ulcer are not always beneficial to the patent. 3) The good results of the elective surgical treatment of the peptic ulcer disease are also found in the patients operated on for acute perforation. The authors propose a therapeutic protocole in which the indications depend more on the general state of the patients than on the classical criteria, and in which a surgical approach to the peptic ulcer disease is emphasized.