PT  - JOURNAL ARTICLE
AU  - Bin-Taleb, Ali K.
AU  - Razzaq, Riyadh A.
AU  - Al-Kathiri, Zaki O.
TI  - Management of perforated peptic ulcer in patients at a teaching hospital
DP  - 2008 Feb 01
TA  - Saudi Medical Journal
PG  - 245--250
VI  - 29
IP  - 2
4099  - http://smj.org.sa/content/29/2/245.short
4100  - http://smj.org.sa/content/29/2/245.full
SO  - Saudi Med J2008 Feb 01; 29
AB  - OBJECTIVE: To explore and analyze the current status in management of patients with perforated peptic ulcers (PPU).METHODS: A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study.RESULTS: A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU was noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.38:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours), wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks.CONCLUSION: Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment, and equipment are needed to reduce the high rate of complications.