Perforated peptic ulcer disease: a review of history and treatment.
BACKGROUND
In the last one hundred years much has been written on peptic ulcer disease and the treatment options for one of its most common complications: perforation. The reason for reviewing the literature was evaluating most common ideas on how to treat perforated peptic ulcers (PPU) in general, opinions on conservative treatment and surgical treatment and summarizing ideas about necessary pre-, per- and postoperative proceedings.


METHODS
All relevant articles found by Medline, Ovid and PubMed search were used.


RESULTS
A hundred articles written between 1929 and 2009 were reviewed. Of these, 9 were about the history of treatment, 7 about conservative treatment, and 26 were about the surgical procedure of which 8 were addressing laparoscopic correction. Overall there is no consensus, but some advice is given. For conservative treatment there are only a few indications. Use of an omental patch is recommended, irrigation and drainage are not. Laparoscopic correction of PPU as well as for definitive ulcer surgery has many advantages.


CONCLUSIONS
Surgery for PPU is still a subject of debate despite more than an era of published expertise, indicating the need for establishing guidelines.
Bertleff
Mariëtta J O E
MJ
Department of Plastic and Reconstructive Surgery, Academic Hospital Maastricht, Maastricht, The Netherlands. doc.bert@online.nl
Lange
Johan F
JF
D000369:Aged, 80 and over; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000266:history / Q000628:therapy*