Mansoor AMM, Uma BB. A prospective study on prevalence of Helicobacter pylori in gastroduodenal perforation. J. Evid. Based Med. Healthc. 2019; 6(37), 2509-2512. DOI: 10.18410/jebmh/2019/515
ABSTRACT
BACKGROUND: Perforation of gastric or duodenal ulcer is one of the serious conditions. Among abdominal emergencies, perforation of peptic ulcer is third in frequency, and acute appendicitis and intestinal obstruction are the most common. Early diagnosis and treatment are very important in reducing the relatively high mortality. Stress is the most important single cause of peptic ulcer in today’s modern life. The phrase “no acid - no ulcer“ does not hold good nowadays, because peptic ulcer is considered to be more of an infective disease, caused by Helicobacter pylori. The route of transmission is mainly by feco-oral route and oro-oral route. We wanted to determine the prevalence of Helicobacter pylori infection in gastroduodenal perforations in Sivagangai Medical College, Sivagangai, during the period between January 2018 to December 2018. METHODS All patients who were diagnosed as perforative peritonitis clinically, radiologically, and in whom explorative laparotomy with omental patch closure was done and patients with history of trauma were excluded. Detailed history of the patients was taken. Patient presented clinically with board like rigidity, with abdominal distension and all blood investigations including complete haemogram, LFT, prothrombin time, serum electrolytes, serum amylase, blood urea, serum creatinine were done. X-ray abdomen erect confirmed the diagnosis. After obtaining the consent for laparotomy and resuscitation, laparotomy was done, mucosal edge biopsy from the ulcer taken and sent for HPE. Biopsy specimen retrieved from edge of the ulcer was preserved in 20% formalin and Giemsa staining was performed. Omental patch closure was done. RESULTS All patients underwent emergency laparotomy. Out of 50 cases 38 were male and the patients’ age range was between 20 and 70 yrs. 46 cases were found to be H. pylori positive and only 4 cases were negative. Postoperatively patients who were H. pylori positive were started on anti H. pylori treatment. CONCLUSIONS There is high prevalence of H. pylori infection in patients with perforated gastroduodenal ulcer.
