title: Simple closure or definitive surgery for perforated duodenal ulcer.
abstract: In the period 1959--1971 a simple operative closure was the initial management of 112 patients with acute perforation of duodenal ulcers. At follow-up 6--18 years after perforation the relevance of the length of ulcer history prior to perforation in deciding upon 'definitive' emergency operation is evaluated. Using such a selection criterion, the rate of misinterpretation at the time of perforation is close on 50%, and half of these patients would be subjected to an apparently unnecessary operation. Furthermore, about 80% of the patients for whom simple closure was not sufficient treatment developed ulcer dyspepsia within the first year after the perforation. Therefore, simple suture of a duodenal perforation with careful clinical follow-up for at least 1 year is recommended.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000601:surgery*; 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; D013536:Suture Techniques