Management of perforated peptic ulcer in patients at a teaching hospital.
OBJECTIVE
To explore and analyze the current status in management of patients with perforated peptic ulcers (PPU).


METHODS
A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study.


RESULTS
A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU was noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.38:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours), wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks.


CONCLUSIONS
Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment, and equipment are needed to reduce the high rate of complications.
Bin-Taleb
Ali K
AK
Department of Surgery, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen.
Razzaq
Riyadh A
RA
Al-Kathiri
Zaki O
ZO
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D015390:Gastric Bypass; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D011708:Pylorus / Q000601:surgery; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality; D012737:Sex Factors; D013276:Stomach Ulcer / Q000150:complications*; D013530:Surgical Wound Infection / Q000401:mortality; D013997:Time Factors; D015167:Vagotomy, Truncal; D015006:Yemen