title: Acute perforated duodenal ulcer. An evaluation of surgical management.
abstract: The surgical management of acute perforated duodenal ulcer has been evaluated in 360 patients. Simple closure was done in 254 patients, with a mortality of 6.7%, a morbidity of 21%, and an average hospital stay of 11.9 days. In 106 patients (29%) who underwent definitive operation for treatment of duodenal ulcer disease at time of perforation, the mortality was 2.8%, the morbidity was 15%, and the average hospital stay was nine days. Follow-up studies of simple closure in patients with no previous ulcer symptoms showed that 72% of the patients remained asymptomatic; in patients with previous ulcer symptoms, only 23% were asymptomatic. Definitive operation for acute perforation is indicated in good-risk patients who have a history of ulcers. Parietal cell vagotomy and simple closure was used in four patients with excellent early results.
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage; D004381:Duodenal Ulcer / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008722:Methods; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011706:Pyloric Antrum / Q000601:surgery; D013714:Tennessee; D014628:Vagotomy