ATTRIBUTES OF PATIENTS WITH PERFORATED DUODENAL ULCER IN DUHOK CITY

  • FERHAD MOHAMMED RASHEED AHMED Specialist Surgeon (General Surgery), Azadi Teaching Hospital, Duhok, Kurdistan Region, Iraq
  • MOWAFAK M. BAHADDIN Assist. Professor, Lecturer, Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
Keywords: Duodenal ulcer perforation, Clinical features, Risk factors

Abstract

https://doi.org/10.31386/dmj.2017.11.2

Background: Perforation of peptic ulcer is regarded as one of the common abdominal surgical emergencies. The objective of this study was to describe the clinical features and potential risk factors among patients with perforated duodenal ulcer in Duhok city.

Subject and Methods: This is a prospective descriptive study done at the Emergency Teaching Hospital in Duhok city, over a period of one year (1st of January,2015- 31st of December,2015).The study included 35patients who were operated upon for perforated duodenal ulcer. The clinical findings and probable risk factors for perforation of the duodenal ulcer were studied.

Results: Age of the patients ranged from 15-80 years; the commonest age group affected was the 20-39 years old (54.2%). Twenty-eight (80%) were males. Helicobacter pylori antibodies were positive of in 26 patients (74.2 %) while history of ingestion of non-steroidal anti-inflammatory drugs in 25 (71.4%). Twenty-one patients (60%) were smokers and 10 (28.5%) alcoholic. Past history of chronic peptic ulcer was present in 12 patients (34.2%), positive family history in 4 (11.4) and history of ingestion of steroid in 2 (5.7%). Duration of symptoms for more than 24 hours was present in 20 patients (57.1%), generalized abdominal pain in 19 (54.2%), epigastric pain in 16 (45.7%), nausea in 18 (51.4%), vomiting in 12 (34.2%) and rigid abdomen in 26 (74.2%).

Conclusions:  Young age, male gender Helicobacter pylori infection, ingestion of non-steroidal anti-inflammatory drugs and smoking, seemed probable risk factors for occurrence of duodenal ulcer perforation. Late presentation was not uncommon.

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References

1. Makela J., Kiviniemi H., Ohtonen P., Laitinen S. Factors that predict morbidity and mortality in patients with perforated peptic ulcers. Eur J Surg.. 2002; 168(8‐9):446-451.
2. Zelickson M., Bronder C., Johnson B., Camunas J., Smith D., Rawlinson D., Von S., Stone H., Taylor S et al. Helicobacter pylori is not the predominant etiology for peptic ulcers requiring operation. Am surg. 2011; 77(8):1054-1060.
3. Murray L., Ian B., Edward H., Alexander F., Ahmad R. Oxford Handbook of Clinical Medicine, 8th Ed., New York: Oxford University Press Inc. 2010;(8): 586.
4. Farsakh NA. Risk factors for duodenal ulcer disease. Saudi Med J. 2002; 23: 168-172.
5. Saber A. Perforated Duodenal Ulcer in High Risk Patients. In: Chai J, editor. Peptic Ulcer Disease. In Tech. Rijeka, Croatia: 2011. p. 271-85.
6. Milosavljevic T, Kostic-Milosavljevic M, Jovanovic I, Krstic M. Complications of peptic ulcer disease. Dig Dis. 2011; 29(5):491-493.
7. Ahmad M., Al Knawy B., Al-Wabel A., Foli K.Duodenal ulcer and Helicobacter Pylori infection at high altitude: experience from south Saudi Arabia. Can J Gastroenterol. Hepatol.. 2001; 11:313-316.
8. Bertleff, M., Lange, J. Perforated Peptic Ulcer Disease: A Review of History and Treatment. Digestive Surgery. 2010; 27, 161-169.
9. Watkins R., Dennison A., et al. What has happened to perforated peptic ulcer? Br J Surg. 1984; 71(10): 774-776.
10. Jhobta R., Attri A., Kaushik R., Sharma R and Jhobta A. Spectrum of perforation peritonitis in India—reviews of 504 consecutive cases. World J EmergSurg.2006; 1:26.
11. Thorsen K., Glomsaker T., Meer A., Soreide K., Soreide J. Trends in diagnosis and surgical management of patients with perforated peptic ulcer. J Gastrointest Surg. 2011; 15: 1329-1335.
12. Noguiera C., Silva A., Santos J., Silva A., Ferreira J., Matos E., Vilaça H. Perforated peptic ulcer: main factors of morbidity and mortality. World J Surg. 2003; 27(7):782-787.
13. Khalil A., Yunas M., Qutbe A., Nisar W., Imran M. Grahm’s omentopexy inclosure of perforated duodenal ulcer. J Med Sci. 2010; 18(2):87-90.
14. Gisbert J., Legido J., Garcia-Sanz I., Pajares J., Helicobacter pylori and perforated peptic ulcer prevalence of the infection and role of non-steroidal anti-inflammatory drugs. Dig Liver Dis. 2004; 36: 116-120.
15. Higham J., Kang J., Majeed A. Recent trends in admissions and mortality due to peptic ulcer in England: increasing frequency of hemorrhage among older subjects. Gut. 2002; 50(4):460-464.
16. Keane T., Dillon B., Afdhal N., McCormack CJ. Conservative management of perforated duodenal ulcer. Br J Surg. 1988; 75: 583-584.
17. Aldoori V. A prospective study of alcohol, smoking, caffeine and the risk of duodenal ulcer in men. Epidemiology. 2003; 8: 420-424.
18. Christenesen A., Bousefield R., Christiansen J. Incidence of perforated and bleeding peptic ulcer before and after introduction of H2 receptor antagonist. Ann Surg. 2002; 207: 46-48.
19. Canoy D., Hart A., Todd C. Epidemiology of duodenal ulcer perforation: a study on hospital admission in Norolk, United Kingdom. Digest liver dis. 2002; 34: 322-327.
20. Donderici O. Effect of Ramadan on peptic ulcer complications. Scand J Gastroenterol. 2006; 29:603-606.
21. Bin-Taleb A., Razzaq R., Al-Kathiri Z. Management of perforated peptic ulcer in patients at a teaching hospital. Saudi Med J. 2008; 29(2): 245-50.
22. Gunay A. Hassan N., Murraid I., prevalence and risk factors for the helicobacter pylori infection among Yemeni dyspeptic patients. Saudi Med J. 2003; 24: 512-517.
23. Ugochukwu A., Amu O., Nzegwu M., Dilibe U. Acute perforated peptic ulcer: on clinical experience in an urban tertiary hospital in south east Nigeria. Int. J. Surg. 2013; 11(3): 223-227.
24. Parmar H., Prajapati M., Shah R. Int J Med Sci. 2013; 2(1): 110-112.
25. - Tylor H. Aspiration treatment of perforated duodenal ulcer. The Lancet. 1998; 1: 7-12.
26. Voutilainen, M., Mäntynen, T., Färkkilä, M., Juhola, M. and Sipponen, P. Impact of non-steroidal anti-inflammatory drug and aspirin use on the prevalence of dyspepsia and uncomplicated peptic ulcer disease. Scand J, Gastroenterol. 2001; 36(8): 817-821.
27. Kurata J. Meta-analysis of risk factors for peptic ulcers. J Clin Gastroenterol. 1997; 24(1):2-17.
28. Sondashi K., Odimba B., Kelly P. A Cross-sectional Study on Factors Associated With Perforated Peptic Ulcer Disease in Adults Presenting to UTH, Lusaka. MJZ. 2012;38(2):15-22.
29. Tukdogan MK, Hekim H, Tuncer I, Aksoy H. The epidemiological and endoscopicaspects of peptic ulcer disease in Van region. East J Med. 1999; 4(1):6-
30. Kocer, B., Surmeli, S., Solak, C., Unal, B., Bozkurt, B., Yildirim, O., Dolapci, M. and Cengiz, O. Mortality and morbidity in patients with perforated peptic ulcer disease. J. Gastroenter.2007; 22(4): 565-570.
31. Fathalah T A, Mahmood M A. Risk factor for perforated duodenal ulcer in Sulaemania city.Zanco J. Med. Sci. 2010; 4(3).
32. Plummer J., Farlane M. Surgical management of perforated duodenal ulcer: the changing scene. W Indian Med J. 2004; 53(6):378-381.
Published
2018-02-08
How to Cite
AHMED, F. M., & BAHADDIN, M. (2018). ATTRIBUTES OF PATIENTS WITH PERFORATED DUODENAL ULCER IN DUHOK CITY. Duhok Medical Journal, 11(1), 8-18. Retrieved from http://dmj.uod.ac/index.php/dmj/article/view/2