CLINICAL STUDY AND SURGICAL MANAGEMENT OF PERFORATED DUODENAL ULCER

CORRESPONDING AUTHOR:
Dr. Rajanna B,
Associate Professor & HOD,
Department of General Surgery,
Hassan Institute of Medical Sciences, Hassan.
Email: drrajannab@gmail.com

ABSTRACT: BACKGROUND: Duodenal ulcer is a very common disease in the southern part of India and complication like perforation is still common and surgical intervention is considered the treatment of choice.⁽¹⁾ METHODS: A prospective study consisting of 70 patients of duodenal perforation presenting as acute abdomen to the casualty department of Victoria hospital and Bowring & Lady Curzon Hospital, Bangalore, between October 2009 to Aug 2011. RESULTS: In our study, presentation of duodenal perforation is common in males (91.4%) between 3^rd to 6^th decades. The incidence of the duodenal perforation is more in those consume spicy food, living in rural areas (59%) and with ‘0’ positive blood group (51%). Most of our patients presented after 48 hours and major post-operative complications observed in these patients (50%). CONCLUSION: Live omental patch closure with technical modifications is still the better operation in perforated duodenal ulcer and definitive procedure are reserved when suitable conditions are present.⁽²⁾ Mortality rate in perforated duodenal ulcer is less when compared to other acute abdominal conditions and is directly related to duration of clinical symptoms, age, severity of dehydration, and peritoneal cavity contamination.

KEYWORDS: Duodenal ulcer, perforation, peritonitis, omentoplasty, trancal vagotony, pyloroplasty.