G. Kishore Babu1, B. Sobha Rani2
INTRODUCTION
Perforated duodenal ulcer, the most catastrophic complication was Associated with high mortality in the past due to late presentation of the patients, delay in surgery and lack of antibiotics. Various authors state that the incidence of peptic ulcer disease and perforation has been declining for the past 3 decades. Because of advances in the medical therapy of peptic ulcer with a wide range of drugs the management of peptic ulcer disease has been changing and the role of surgery has been declining. Perforation is usually seen in 3rd and 4th decades with a male preponderance and the epidemiological trend is not the same worldwide. Incidence is slightly declining in western countries. The present study has been done during the period between 2013 and 2014 in S. V. R. R. Government general hospital Tirupati.
AIMS AND OBJECTIVES
The aim of the present study is to analyze the probable factors for increase in incidence of duodenal ulcer perforation, with particular emphasis on assessment of impact of H2 receptor antagonists and Proton Pump inhibitors on the incidence of perforation.
STUDY SETTING
S. V. Medical College, Department of General Surgery, Tirupati.
STUDY PERIOD
Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2013 to October 2014.
INCLUSION CRITERIA
Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have peritonitis due to duodenal ulcer perforation.
EXCLUSION CRITERIA
Patients with peritonitis due causes other than duodenal ulcer.
STUDY METHOD
Prospective Observational study among the selected patients. Total numbers of peptic ulcer cases that were admitted in this hospital and treated either medically or surgically were noted. The details of their clinical history and findings, investigation reports, operative findings, post-operative complications were recorded. Simple closure was performed for all the cases and thorough peritoneal toilet was done in all cases. All were put on appropriate antibiotics. All the patients were carefully followed in the post-operative period and their progress was noted.
CONCLUSION
The mortality in perforated peptic ulcer has been reduced owing to early approach to hospital, diagnosis, prompt surgical treatment and appropriate and adequate antibiotics. Thorough peritoneal toilet along with adequate fluid and electrolyte replacement are some of the important factors, which have improved the prognosis of duodenal ulcer perforation.
