PEPTIC ULCER PERFORATION: EXPERIENCE IN THE RIVERINE SOUTH WESTERN NIGERIA

George Chilaka Obonna

Abstract

BACKGROUND: Apart from bleeding, gastric outlet obstruction and intractability, perforation is one of the complications of peptic ulcer. Management of this condition which may be operative or non-operative would involve eradication of Helicobacter pylori and the use of proton pump inhibitors. The study focused on the details of clinical features, findings at surgery and outcome of patients who were operated upon for peptic ulcer perforation.

METHODS: This is a cross sectional study of 100 patients with intra-operative diagnosis of peptic ulcer perforation. This study was done at the state specialist hospital Okitipupa which serves the riverine communities of Ondo State. The case files of 100 patients with such diagnosis at open surgery over a 6yrs period from June 2012 to June 2018 were retrieved from the records department. Clinical data obtained from the patients’ case files were analyzed using SPSS version 20.

RESULTS: There were 80 (80%) males and 20 (20%) females with age range from 15-90years. The male to female ratio was 4:1. The overall mean age of the patient was 47±19years. Twenty (20%) patients were in shock on admission. Simple closure with onlay omental patch reinforcement was the operation done in all the patients. Ninety patients were well and discharged after surgery while 10 died. The overall mortality rate was 10%.Peptic ulcer perforation is not a rare occurrence in our environment.

CONCLUSION: Simple closure with on-lay omental patch reinforcement, with proton pump inhibition and eradication of Helicobacter pylori without definitive antiulcer surgery were the management approach adopted in our centre.

Keywords

Ulcer perforation, Simple closure, pedicled omental reinforcement

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