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Publication Type
Journal Article
Author, Analytic
Plummer, J. M. ; McFarlane, Michael E. ; Newnham, Mark S.
Author Affiliation, Ana.
Department of Surgery, Radiology, Anaesthesia and Intensive Care
Article Title
Surgical Management of Perforated Duodenal Ulcer: The Changing Scene
Medium Designator
n/a
Connective Phrase
n/a
Journal Title
West Indian Medical Journal
Translated Title
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Reprint Status
Refereed
Date of Publication
2004
Volume ID
53
Issue ID
6
Page(s)
378-381
Language
n/a
Connective Phrase
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Location/URL
n/a
ISSN
0043-3144
Notes
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Abstract
To determine the management of perforated duodenal ulcer at the University Hospital of the West Indies (UHWI) in this era of Helicobacter pylori, the medical records of all patients seen at the UHWI during the period July 1997 to June 2002 with an intra-operative diagnosis of perforated peptic ulcer were reviewed. The records were analysed for the following: age, gender, duration of symptoms, non-steroidal anti-inflammatory drug use, smoking status, operative repair duration of hospitalization, Helicobacter pylori status and medical therapy, peri-operative complications, mortality and recurrence. Ninety per cent of the cases were males. All females in whom perforation occurred were age 50 years and older compared to males where 58% of cases presented before age 50 years. Perforations in acute ulcers occurred in 80% of cases. The majority of patients were male smokers. Non-steroidal anti-inflammatory drug use was also an important risk factor in elderly females. Simple surgical closure and standard triple therapy antibiotics to eradicate Helicobacter pylori was the most common treatment offered. Mortality was one per cent and follow-up poor but 11% of patients had documented recurrent peptic ulceration. In this study population, perforated duodenal ulcer occurred overwhelmingly in males less than 50 years of age. There is a trend towards exclusive simple surgical closure and H pylori eradication at the UHWI for patients with perforated duodenal ulcer but this needs to be supported by documentation of H pylori prevalence in the population of patients presenting with perforated peptic ulcers.....
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