Dhruvesh Sheth, Jatin Patel, Arth Chaudhary

A STUDY ON PEPTIC PERFORATION- RELATIONSHIP OF OPERATION TIME INTERVAL WITH MORTALITY

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The peptic perforation (PUO) is one of the commonest abdominal surgical emergencies. Common causes are H.pylori, increased inadvertent use of NSAIDS, smoking and stress of modern life. During last few years there has been great revolution in availability of the newer broad spectrum antibiotics, better understanding of disease, effective resuscitation, prompt surgery under modern anaesthesia techniques, and intensive care unit resulted in reducing the mortality. However still many risk factors are associated with prognosis, so aim our study to nd out the signicance of the Perforation-Operation Interval with respect to prognosis, in patients with peritonitis which is caused by peptic ulcer perforation. Methods: A prospective randomized study was conducted of 50 patients in Narendra Modi Medical College (L.G. Hospital, Maninagar, Ahmedabad). All were indoor patients with diagnosis of peptic perforation in stomach and/or duodenum excluding other sites. Each patient was study in detail with relevant clinical history, examination, laboratory investigations and management. The perforation-operation interval was calculated from the time of onset of the symptoms like severe abdominal pain or vomiting till the time the patient was operated. Results: Out of the 50 patients 42 were males and 8 were females, with a male : female ratio of 5.2:1. Their ages ranged between 16-70 years. Out of the 50 patients, 26 patients (52%) presented within 12 hours of the onset of severe abdominal pain (Group A), 13 patients (26%) presented between 12-24 hours of the onset of severe abdominal pain (Group B) and 11 patients (22%) presented after 24 hours. There was no mortality in Group Aand the morbidity was more in Group B and Group C. There were 2(4%) deaths in Group C. Conclusion: The problem of peptic ulcer perforation with its complication, can be decreased by decreasing the perforation –operation time interval, which as per our study, appeared to be the single most important mortality and morbidity indicator in peptic ulcer perforation

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