title: Natural history of perforated duodenal ulcers treated by suture closure.
abstract: Of 50 patients with a perforated duodenal ulcer treated with simple suture closure, 36 (72%) had symptoms before the perforation for a mean period of 9.9 years. 24 of the 36 (66.6%) acquired further symptoms or complications at 1--48 months (mean 11 months) after the operation, whereas only 2 of the 14 patients (14%) who were symptom-free preoperatively had further complications. At follow-up 48% of the patients were still free of symptoms. Simple suture closure with a "wait and see" policy remains the treatment of choice, and a prospective clinical study to evaluate definitive emergency surgery for duodenal ulcer has been cancelled.
mesh_terms: D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications*; D004386:Duodenum / Q000601:surgery*; D004415:Dyspepsia / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D013537:Sutures; D013997:Time Factors; D014628:Vagotomy