title: Helicobacter pylori status and endoscopy follow-up of patients having a history of perforated duodenal ulcer.
abstract: BACKGROUND
  The aim of this study was to determine whether the recurrence of symptoms or ulcer disease in patients with a history of perforated duodenal ulcer is related to Helicobacter pylori infection.
  
  
  METHODS
  One hundred sixty-three consecutive patients with history of perforated duodenal ulcer unrelated to nonsteroidal anti-inflammatory drugs underwent upper endoscopy. Any recurrent symptoms or complications were documented. Regardless of the endoscopic findings, three antral biopsy specimens were taken for histologic examination and a rapid urease test.
  
  
  RESULTS
  There was a preponderance of men (male/female = 5.3:1). The mean age was 55.9 years. Sixty-seven (41.1%) patients gave a history of recurrent epigastric pain, seven of whom also had a history of bleeding ulcer. Upper endoscopy was performed at a mean of 74.5 +/- 7.1 months after operation. Positive endoscopic findings were noted in 68 (41.7%) patients; H. pylori was found in the biopsy specimens from 77 (47.2%) patients. Recurrent duodenal ulcer was found in 29 (17.8%) patients and was significantly related to male gender, recurrent epigastric pain, bleeding ulcer, longer interval from previous operation, and positive H. pylori status. Positive H. pylori status and male gender were independent factors associated with recurrent duodenal ulcer.
  
  
  CONCLUSIONS
  Recurrent ulcer disease in patients with a history of perforated duodenal ulcer is related to H. pylori infection.
authors.affiliation: Division of Upper Gastrointestinal Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China.
authors.forename: K M
authors.initials: KM
authors.lastname: Chu
authors.forename: K F
authors.initials: KF
authors.lastname: Kwok
authors.forename: S Y
authors.initials: SY
authors.lastname: Law
authors.forename: H H
authors.initials: HH
authors.lastname: Tuen
authors.forename: P H
authors.initials: PH
authors.lastname: Tung
authors.forename: F J
authors.initials: FJ
authors.lastname: Branicki
authors.forename: J
authors.initials: J
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010439:Peptic Ulcer Perforation / Q000175:diagnosis* / Q000209:etiology; D012008:Recurrence