title: Nonoperative treatment of perforated duodenal ulcer.
abstract: This report concerns 35 adult patients in whom perforation of a duodenal or prepyloric ulcer was treated nonoperatively between July 1979 and April 1988 at the Los Angeles County--University of Southern California Medical Center, Los Angeles. Each patient had pneumoperitoneum with clinical evidence of peritonitis, and a gastroduodenogram documented a sealed perforation. The ulcer was believed to be acute in 27 patients and chronic in 8. These 35 cases represent 12% of 294 cases of duodenal and prepyloric peptic ulcers with perforation treated during the same period. An intra-abdominal abscess developed in 1 of the 35 patients. Reperforation did not occur. The mortality rate for the 259 cases treated operatively during this period was 6.2%; the mortality rate of the 35 cases treated nonoperatively was 3%. Duodenal ulcer can be safely treated nonoperatively when a gastroduodenogram documents self-sealing.
authors.affiliation: Department of Surgery, University of Southern California School of Medicine, Los Angeles 90033.
authors.forename: T V
authors.initials: TV
authors.lastname: Berne
authors.forename: A J
authors.initials: AJ
authors.lastname: Donovan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D011027:Pneumoperitoneum / Q000188:drug therapy / Q000209:etiology