ABSTRACT: | Full Text PDF
OBJECTIVE: To determine the outcome of patients operated for perforated dudodenal ulcer.
STUDY DESIGN: Case Series.
PLACE & DURATION: Department of surgery, Chandka Medical College, Hospital Larkana, from April 2008 to Nov 2009.
PATIENTS AND METHODS: 76 consecutive patients, diagnosed as perforated duodenal ulcer were included in study, while patients of traumatic perforation were excluded. After adequate resuscitation, emergency laparotomy and modified Graham Patch procedure was performed in every patient. All pre-operative parameters including biodata, duration of symptoms, smoking and drug history, size of perforation, and post operative complications were entered in designed proforma.
RESULT: In this study all the patients were male with median age of 48.42 years and standard deviation was 10.37. Duration of symptoms was < 24 hours in 52(68%) patients while more than 24 hours in 24(31%) patients. 42 (55%)patients gave the history of NSAID and PPI. 36(47%) were smoker, 17 (22%) diabetic and 8( 10%) were uremic. Perforation was present in first part of duodenum in all cases. Mean size of perforation and standard deviation was 0.939 cm +/- 0.357 . Mean operative time and standard deviation was 66.97 min +/- 10.75. Post operative complicatons were observed in 22(28.94%). Mean hospital stay was 7.89 days with standard deviation of 2.523, while 3(4%) patients expired.
CONCLUSION:Duodenal perforation is life threatening condition most common in middle aged peoples.Smoking, Stress, Steroids and NSAIDS are common risk factors. Delayed arrival and comorbid conditions increase the morbidity but has less effect on mortality in post operative patients. Simple repair and omentopexy & use of PPI along with H.pylori eradication therapy in +ve patients is sufficient treatment.