Abstract

Corruent study was made to study about the treatment ,clinical presentations and outcomes of the patients suffering from perforated peptic ulcer disease.Peptic ulcer perforation (PUP) is one of the commonest perforations of GIT. The peptic ulcer disease has reduced due to improvements in diagnosis by endoscopy and anti-ulcer drugs advancement with eradication of Helicobacter pylori. Perforation occurs in approximately 7% of patients hospitalized for peptic ulcer disease. Duodenal perforation tends to occur in the anterior wall while gastric ulcers may perforate anteriorly or posteriorly. Concomitant hemorrhage should suggest the presence of a ‘kissing’ulcer (ulcers involving anterior and posterior duodenal walls simultaneously).^*The objective of this study was to analyze the clinical presentation, treatment and outcomes of the patients with perforated pepticulcer.It was a prospective observational study and was conducted at RMMCH between November 2008 and April 2009. Data collected from the data collection form were entered in the Microsoft excel programme and analyzed.Total 65 patients were studied during this study. Male to female ratio was represented by 1.1: 1. Their median age was 30 years and the age group was 21- 30 years. The average duration of disease was 7 days. 63.07% of the patients had no previous history of peptic ulcer disease. 18.4% of the patients has  previous history of taking NSAID’s, 58.4% of patients has the history of taking alcohol, 40% of the patients are smokers.Complicati0on rate was 21.5%.Factors related to the complications are past illness, delay bin the treatment & acute perforation. The mortality rate was 6.1%. Factors associated with the mortality are the patients with ≥40 years of age, shock at admission, gastric ulcers, co-morbidities, poly-pharmacy. The average duration of hospital stay was 14 days.In patients with perforated peptic ulcer, the non-operative treatment with careful observation and resuscitation may be safely allowed, except in patients over 70 years old, and that the use of such an observation period can obviate the need for emergency surgery.It is the most common problem mainly affecting the males. Simple closure with omental patch is giving better results. But omental closure followed by the eradication of Helicobacter pylori was giving more excellent results.outcomes were Fourteen (21.5%) patients were reported with post-operative complications. Of these Cellulitis (50%) was the most common complication. The overall length of hospital stay ranged from 1 to 50 days with an average of 14 days. During this study nine patients were died. So the mortality rate was 6.1%.