Clinical pattern of perforated prepyloric and duodenal ulcer at Ile-Ife, Nigeria.
High morbidity and mortality often attend perforation of duodenal ulcer. Over a 6-year period at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, 22 patients presented with prepyloric or duodenal ulcer perforations--a relatively low yearly rate of about four. Of the 15 patients evaluated, approximately three-quarters were working class young men and eight (53%) had no ulcer history. The high morbidity, and 20% mortality rate, observed were attributable to late presentation and the presence of advanced bacterial peritonitis in 67% of the patients at admission. Imprecise clinical features in those with small perforations led to misdiagnosis in a third of cases. Treatment of perforations in the majority (93%) of patients was by simple closure or truncal vagotomy and pyloroplasty. An increase in patients' awareness of the potentials of optimal operative management should encourage earlier presentation.
Lawal
O O
OO
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Fadiran
O A
OA
Oluwole
S F
SF
Campbell
B
B
D000293:Adolescent; D000328:Adult; D004381:Duodenal Ulcer / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010439:Peptic Ulcer Perforation / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors