scholarly journals Perforation Peritonitis and the Developing World

ISRN Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Rajandeep Singh Bali ◽  
Sushant Verma ◽  
P. N. Agarwal ◽  
Rajdeep Singh ◽  
Nikhil Talwar
Keyword(s):  
Peptic Ulcer ◽  
Single Unit ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
Gastric Ulcers ◽  
Peptic Ulcer Perforation ◽  
Care Hospital ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Perforation Peritonitis

Background. Perforation peritonitis is the one of the commonest emergency encountered by surgeons. The aim of this paper is to provide an overview of the spectrum of perforation peritonitis managed in a single unit of a tertiary care hospital in Delhi. Methods. A retrospective study was carried out between May 2010 and June 2013 in a single unit of the department of Surgery, Lok Nayak Hospital, Delhi. It included 400 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included. Results. The commonest cause of perforation peritonitis included 179 cases of peptic ulcer disease (150 duodenal ulcers and 29 gastric ulcers) followed by appendicitis (74 cases), typhoid fever (48 cases), tuberculosis (40 cases), and trauma (31). The overall mortality was 7%. Conclusions. Perforation peritonitis in India has a different spectrum as compared to the western countries. Peptic ulcer perforation, perforating appendicitis, typhoid, and tubercular perforations are the major causes of gastrointestinal perforations. Early surgical intervention under the cover of broad spectrum antibiotics preceded by adequate aggressive resuscitation and correction of electrolyte imbalances is imperative for good outcomes minimizing morbidity and mortality.

scholarly journals Prevalence of Peptic Ulcer Disease among the Patients with Abdominal Pain at Tertiary Care Institute of Gujarat

2020 ◽  
Vol 3 (2) ◽  
pp. 30-32
Author(s):  
Rahul Charpot ◽  
Jaydeep M Gadhavi
Keyword(s):  
Peptic Ulcer ◽  
Abdominal Pain ◽  
Peptic Ulcer Disease ◽  
Tertiary Care ◽  
Gastric Ulcers ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Care Institute ◽  
Disease Information ◽  
One Year

Background: To establish the occurrence of peptic ulcer disease amid the Subjects with abdominal pain at tertiary care institute of Gujarat. Subjects and Methods: present research was performed at the Department of Surgery, tertiary care institute of Gujarat, for the period of one year in 200 patients with abdominal pain and diagnosed with peptic ulcer disease. Information was composed utilizing pre-designed questionnaire. Results:The majorities of participants was females, most were aged between 18 to 25 years. Around 97% had pain in the epigastric region. Gastric ulcers preponderate for 65% patients in current research, except refused during the later existence of the epoch, as the occurrence of duodenal ulcers stayed stable, however amplified rather the later phase. Conclusion: An extensive diversity of subjects with abdominal pain was documented amid the subjects. On the other hand, the socio-economic situation and educational levels of the Subjects with the illness were below par.

scholarly journals A clinical study of factors affecting the prognosis in duodenal ulcer perforation cases in tertiary care hospital, Kanchipuram district

2019 ◽  
Vol 6 (12) ◽  
pp. 4290
Author(s):  
Dhinesh Babu K. ◽  
M. Bhaskar
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Tertiary Care ◽  
Peptic Ulcer Perforation ◽  
Care Hospital ◽  
Chronic Alcoholic ◽  
Factors Affecting ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Duodenal Ulcer Perforation

Background: Peptic ulcer disease is an erosion of the lining of the stomach or duodenum. It is associated with potentially life-threatening complications such as bleeding, perforation and obstruction. The main predisposing factors for peptic ulcer perforation are smoking, use of non-steroidal anti-inflammatory drugs (NSAIDs), chronic stress, Helicobacter pylori infection, and age >60 years. In recent years, with introduction of proton pump inhibitors and increased knowledge of duodenal ulcer perforation (DUP) has decreased the incidence of DUP.Methods: 50 patients with DUP were studied prospectively with respect to age, gender, use of NSAIDs, morbidity, mortality and complications.Results: Out of 50 patients, the mean age of incidence DUP was 46 yrs, which is more common in males. And also 48% patients were chronic alcoholic and 52% patients were chronic smokers. Moreover, 14% patients were chronic NSAIDs users.Conclusions: Factors such as age, gender, use of NSAID, Alcohol and smoking affects the life expectancy of the patients, which leads to morbidity and mortality.

scholarly journals Acute Upper Gastrointestinal Bleeding in a Tertiary Care Centre of Nepal

2017 ◽  
Vol 56 (206) ◽  
Author(s):  
Mukesh Sharma Paudel ◽  
Sudhamshu KC ◽  
Amrendra Kumar Mandal ◽  
Nandu Silwal Poudyal ◽  
Ramila Shrestha ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Tertiary Care ◽  
Gastric Ulcers ◽  
Peptic Ulcers ◽  
Tertiary Care Centre ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Variceal Bleed ◽  
Upper Gastrointestinal

Introduction: AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community.Methods: We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu. We identified the culprit lesions by upper gastrointestinal endoscopy.Results: The average age of patients with AUGIB was 51.6 years with 59 (59%) males. Duodenal ulcers are most common 29 (29%), followed by varices 23 (23%) and gastric ulcers 14 (14%). More than one lesion was identified in 38 (38%) patients. Patients with variceal bleed were more likely to present with hematemesis alone as compared to those with ulcer bleed (p=0.005). Variceal bleed patients presented earlier to the hospital (p=0.005), had lower MAP at presentation (p=0.0002), had lower hemoglobin level (p=0.0001) and higher serum creatinine level at presentation (p=0.001). Patients with variceal bleed were more likely to have consumed alcohol 20 (86.9%) and patients with ulcer bleed were more likely to be smokers 29 (67.4%) or consume tobacco 14 (32.5%) (p=0.006).Conclusions: Ulcer related bleeding is still the most common cause of AUGIB. Many patients with AUGIB have more than one lesions identified during upper gastrointestinal endoscopy.Keywords:  bleeding; endoscopy; peptic ulcer; upper gastrointestinal;varices. [PubMed]

FEASIBILITY OF ERAS (ENHANCED RECOVERY AFTER SURGERY) PROTOCOL IN PATIENTS UNDERGOING EMERGENCY REPAIR FOR PERFORATED PEPTIC ULCER DISEASE IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 41-43
Author(s):  
Chayan Rui ◽  
Chandan Roy Choudhury ◽  
Puspak Ghosh
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Tertiary Care ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Care Hospital ◽  
Ulcer Disease ◽  
Emergency Repair

Introduction: The surgical treatment of perforated peptic ulcer disease has evolved in parallel to advances in medical treatment of Peptic Ulcer Disease. Objective: To investigate the feasibility of ERAS (Enhanced Recovery after Surgery) Pathways in patients undergoing emergency repair for Perforated peptic ulcer disease. Materials and methods: Institutional based prospective analytical study. Indoor patients in Dept. of General Surgery in Medical College and Hospital Kolkata. January 2019 to June 2020. Study was conducted for 18 months.14 months was provided for data collection. Next 2 months for statistical analysis and another 2 months for thesis writing and submission. Conclusion: ERAS pathway (with some modications) seems to be safe and feasible in a highly selected subset of patients undergoing emergency Omental grahams patch repair of Perforated Peptic Ulcer Disease

scholarly journals Comparative study between POMPP score versus Boey score to predict morbidity and mortality in peptic perforation peritonitis

2021 ◽  
Vol 8 (2) ◽  
pp. 543
Author(s):  
Bhanu Prakash K. R. ◽  
Subhas Patil ◽  
Manasa Mohan
Keyword(s):  
Peptic Ulcer ◽  
Morbidity And Mortality ◽  
High Rate ◽  
P Value ◽  
Peptic Ulcer Perforation ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Perforation Peritonitis

Background: Peptic ulcer disease (PUD) results from an imbalance between stomach acid-pepsin and mucosal defense barriers. It affects 4 million people worldwide annually. Peptic ulcer perforation is one of the most common surgical emergencies and is associated with a high rate of morbidity and mortality. This is due to presence of various risk factors among the population like H. pylori infection, long term NSAID use, alcohol ingestion, smoking and steroid use. Peptic ulcer perforation peritonitis usually requires an emergency surgical intervention and hence the need for this study, to compare POMPP and Boey scores as predictors of morbidity and mortality in patients with peptic perforation peritonitis.Methods: This prospective observational study was conducted in the hospitals attached to Bangalore Medical College and Research Institute from November 2018 to May 2020. All patients above 18 years with features of hollow viscus perforation with per-operative finding of perforated peptic ulcer were included in the study. Patients with histopathology suggestive of malignancy were excluded.Results: A total of 65 patients were included in the study. On analysis of the data by Chi-square test, P value of both POMPP and Boey scores was found to be <0.05 which is statistically significant. The most important predictive factors of mortality and morbidity were duration of perforation >24 hours, age >65 years and pre-operative shock.Conclusions: Both scoring systems are easy to use and can assist in accurate and early identification of high-risk patients and are important in predicting mortality and morbidity in patients with peptic ulcer perforation.

Peptic Ulcer Disease in Children: Etiology, Clinical Findings, and Clinical Course

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 410-414
Author(s):  
Brendan Drumm ◽  
J. Marc Rhoads ◽  
David A. Stringer ◽  
Phillip M. Sherman ◽  
Lynda E. Ellis ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Emergency Surgery ◽  
Clinical Course ◽  
Clinical Findings ◽  
Gastric Ulcers ◽  
Peptic Ulcers ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Initial Symptoms

The records of all children with peptic ulcer disease at the Hospital for Sick Children were retrospectively evaluated, excluding neonates, throughout a 5-year period. Only cases with a definite ulcer crater identified either at endoscopy or at surgery were included. There were 36 patients, 20 boys and 16 girls. Duodenal ulcers were more common than gastric ulcers (2.8:1). Ages ranged from 3 months to 17 years, with a mean age of 10 years. Patients were reviewed with respect to etiology of peptic ulcer disease, age when first examined, initial symptoms, and clinical course. Patients were divided into two groups, those with primary (n = 19) and those with secondary (n = 17) peptic ulcer disease. All peptic ulcers in patients younger than 10 years of age were secondary in nature. Secondary ulcers occurred generally in association with a severe underlying illness (11/17), and many ulcers necessitated emergency surgery because of perforation and/or severe hemorrhage (8/17). None of these patients had chronic or recurrent symptoms. In contrast, in children with primary peptic ulcer disease, initial symptoms were more benign. Most patients had abdominal pain and only one required emergency surgery. Children with primary duodenal ulcer disease had a high incidence of recurrent symptoms (67%), however, with surgery for intractable disease necessitated in 40%. Single-contrast barium meals were found to be unreliable in establishing a diagnosis of peptic ulcer disease, particularly cases of gastric ulcer disease.

scholarly journals CagA Antibodies in Japanese Children with Nodular Gastritis or Peptic Ulcer Disease

2000 ◽  
Vol 38 (1) ◽  
pp. 68-70
Author(s):  
Seiichi Kato ◽  
Toshiro Sugiyama ◽  
Mineo Kudo ◽  
Kenji Ohnuma ◽  
Kyoko Ozawa ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Gastric Ulcers ◽  
Enzyme Linked Immunosorbent Assay ◽  
Igg Antibodies ◽  
Japanese Children ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Nodular Gastritis ◽  
H Pylori

ABSTRACT cagA + Helicobacter pylori strains have been linked to more severe gastric inflammation, peptic ulcer disease, and gastric cancer in adults, but there have been few studies of cagA in children. We examined the relationship between H. pylori cagA status and clinical status in Japanese children. Forty H. pylori -positive children were studied: 15 with nodular gastritis, 5 with gastric ulcers, and 20 with duodenal ulcers. H. pylori status was confirmed by biopsy-based tests and serum anti- H. pylori immunoglobulin G (IgG) antibody. As controls, 77 asymptomatic children with sera positive for anti- H. pylori IgG were enrolled. Levels of IgG antibodies to CagA in serum were measured by an antigen-specific enzyme-linked immunosorbent assay. In 16 patients with successful H. pylori eradication, posttreatment levels of CagA and H. pylori IgG antibodies also were studied. The CagA antibody seropositivities of asymptomatic controls (81.8%) and patients with nodular gastritis, gastric ulcers, and duodenal ulcers (80.0 to 95.0%) were not significantly different. Compared with pretreatment levels of CagA antibodies, posttreatment levels decreased progressively and significantly. We conclude that, as in Japanese adults, a high prevalence of cagA + H. pylori strains was found in Japanese children, and that there was no association with nodular gastritis or peptic ulcer disease. In the assessment of eradicative therapies, monitoring of serum anti-CagA antibodies does not appear to offer any direct benefit over monitoring of anti- H. pylori antibodies.

scholarly journals Helicobacter pylori cag pathogenicity island genes: clinical relevance for peptic ulcer disease development in Brazil

2007 ◽  
Vol 56 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Rejane Mattar ◽  
Sergio Barbosa Marques ◽  
Maria do Socorro Monteiro ◽  
Anibal Ferreira dos Santos ◽  
Kiyoshi Iriya ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Gastric Ulcers ◽  
Disease Development ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Significant Difference ◽  
H Pylori ◽  
The Right

The purpose of this study was to verify whether the presence of any of the Helicobacter pylori cagPAI genes or segments – cagA, cagA promoter, cagE, cagM, tnpB, tnpA, cagT and the left end of the cag II (LEC) region – would be a useful marker for the risk of peptic ulcer disease development. H. pylori DNA extracted from positive urease tests of 150 peptic ulcer patients and 65 dyspeptic controls was analysed by PCR. Duodenal ulcers were present in 110, gastric ulcers in 23 and both gastric and duodenal ulcers in 17 patients. A significant association (P <0.001) was found between a conserved cagPAI and peptic ulcer disease (34 %). The positivity of the cagA gene varied according to the region of the gene that was amplified. The region near to the promoter was present in almost all of the H. pylori isolates (97.2 %). The segment from nt 1764 to 2083 and the extreme right end were frequently deleted in the isolates from the controls (P <0.01). The positivity of the promoter region of cagA and cagT, cagE, cagM and LEC showed a significant difference between the isolates from peptic ulcer patients and from the controls (P <0.01). Patients usually had moderate gastritis; however, the intensity of the active inflammation was higher in the peptic ulcer group (P <0.001). cagT, cagM, LEC and the right end terminus of the cagA-positive H. pylori isolates were associated with a 27-fold, 8-fold, 4-fold and 4-fold risk of peptic ulcer disease, respectively, and may be useful markers to identify individuals at higher risk of peptic ulcer disease development in Brazil.

scholarly journals Feasibility of laparoscopic repair of peptic ulcer perforation

2021 ◽  
Vol 8 (5) ◽  
pp. 1526
Author(s):  
Sanjay Sisodiya ◽  
Badri Prasad Patel
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Laparoscopic Repair ◽  
Peptic Ulcer Perforation ◽  
Concomitant Disease ◽  
Wound Infections ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
Early Return ◽  
Perforation Peritonitis

Background: Perforation is a common complication of peptic ulcer disease and presents as Perforation peritonitis. It has the highest number of mortality among all complications (≈15%). In spite of modern progress in the management, it is still a life-threatening catastrophe. Emergency surgery for complicated cases required in 7% of hospitalized peptic ulcer disease patients. Factors such as >24 hours of history, concomitant disease, shock, post operated wound infections, all are associated with increase in mortality and morbidity.Methods: A Prospective, observational, single hospital base study done during the period from 2016 to 2020 in the Department of Surgery, Gandhi medical college Bhopal. Sample size was taken 63Results: 52 out 63 cases presented with perforation peritonitis included under study period, 11 cases were excluded due to death and absconding of cases. In rest 52 cases, 15 of them went through laparoscopic repair, 28.85% of the cases were shifted directly to ORG.Conclusions: Laparoscopic repair of peptic ulcer perforation is feasible if patient presents early to the hospital. All perforation peritonitis should give fair chance to repair laparoscopically if patient’s general condition and anesthetic permits. This is a good alternative for conventional open surgery with less post-operative pain, early return to normal activities, less hospital stays and few postoperative wound infections. Thus it can significantly decrease the economic burden. 

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