AETIOLOGICAL FACTORS OF NON-TRAUMATIC DUODENAL PERFORATION

Authors

  • Muhammad Siddique Khan Department of Surgery, Ayub Teaching Hospital, Abbottabad
  • Junaid Zeb Department of Surgery, Ayub Teaching Hospital, Abbottabad
  • Ashfaq Ahmad Department of Surgery, Ayub Teaching Hospital, Abbottabad
  • Amer Zaman Department of Surgery, Ayub Teaching Hospital, Abbottabad

Keywords:

Duodenal perforation, H. pylori, NSAIDS, Ulcer, Bleeding

Abstract

Background: Each year peptic ulcer disease affects 4 million people around the world. Perforation of the duodenum due to peptic ulcer remains a considerable medical problem causing high morbidity and mortality. This study aimed to determine the major aetiological factors of non-traumatic duodenal perforations. Methods: It was a cross-sectional study carried out in Surgical ‘B’ Unit, Ayub Teaching Hospital, Abbottabad, Pakistan from 15th Jun 2012 to 15th May 2015. One hundred and eighty-six patients were recruited for the study. Data was collected and analysed on SPSS-23. Results: Mean age of the study participants was 48.4±7.14 years. Male to female ratio was 3:5. The main causative agent was H. pylori (54.30%), 22.04% were smokers, 6.99% had history of using NSAIDS, and 31 (16.67%) patients had more than one causative factor. There was strong association found between age groups and socio-economic status (p=0.004), and literacy level of the respondents (p=0.003). Conclusion: Non-perforated duodenal ulcers are significantly associated with middle-aged people, low socioeconomic status, NSAIDS, smoking, and H. pylori.

Pak J Physiol 2017;13(1):19–21.

Downloads

Download data is not yet available.

References

1. Zelickson MS, Bronder CM, Johnson BL, Camunas JA, Smith DE, Rawlinson D, et al. Helicobacter pylori is not the predominant etiology for peptic ulcers requiring operation. Am Surg 2011;77(8):1054–60.
2. Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg 2010;27(3):161–9.
3. Lau JY, Sung J, Hill C, Henderson C, Howden CW, Metz DC. Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion 2011;84:102–3.
4. Thorsen K, Soreide JA, Kvaloy JT, Glomsaker T, Soreide K. Epidemiology of perforated peptic ulcer: age- and gender-adjusted analysis of incidence and mortality. World J Gastroenterol 2013;19:347–54.
5. Yang WC, Chen CY, Wu HP. Etiology of non-traumatic acute abdomen in pediatric emergency departments. World J Clin Cases 2013;1(9):276–84.
6. Machado NO. Management of duodenal perforation post-endoscopic retrograde cholangiopancreatography. When and whom to operate and what factors determine the outcome? A review article. JOP 2012;13(1):18–25.
7. Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician 2007;76:1005–12.
8. Moller MH, Adamsen S, Wojdemann M, Moller AM. Perforated peptic ulcer: how to improve outcome? Scand J Gastroenterol 2009;44:15–22.
9. Thorsen K, Glomsaker TB, von Meer A, Søreide K, Søreide JA. Trends in diagnosis and surgical management of patients with perforated peptic ulcer. J Gastrointest Surg 2011;15:1329–35.
10. Haider I, Hussain D, Mohammad A. Spectrum of Helicobacter pylori in 100 patients presenting with perforated duodenal ulcer. J Postgrad Med Inst 2011;25:347–51.
11. Lanza FL, Chan FK, Quigly EM. Practice parameters committee of the American College of Gastroenterology. Guidelines for prevention of NSAID related ulcer complications. Am J Gastroenterol 2009;104:728–38.
12. Chalya PL, Mabula JB, Koy M, McHembe MD, Jaka HM, Kabangila R, et al. Clinical profile and outcome of surgical treatment of perforated peptic ulcers in Northwestern Tanzania: A tertiary hospital experience. World J Emerg Surg 2011;6:31. doi: 10.1186/1749-7922-6-31.
13. Bertleff MJ, Lange JF. Laparoscopic correction of perforated peptic ulcer: first choice? A review of literature. Surg Endosc 2010;24:1231–9.
14. Ohene-Yeboah M, Togbe B. Perforated gastric and duodenal ulcers in an urban African population. West Afr J Med 2006;25:205–11.
15. Dakubo JC, Naaeder SB, Clegg-Lamptey JN. Gastro-duodenal peptic ulcer perforation, East Afr Med J 2009;86(3):100–9.
16. Karbhari SS, Hosamani V, Dhaded RB. An overview of management of small intestinal perforation. J Evolution Med Dent Sci 2014;70:14883–9.
17. Malik SA, Azad M, Ahmad Z, Qureshi A, Ahmed MN. Presentation and management of gastro duodenal perforations in the era of NSAIDS. JK Pract 2011;16(1–2):14–16.
18. Surapaneni S, Rajkumar S, Reddy-A VB. The Perforation-Operation time interval: An important mortality indicator in peptic ulcer perforation. J Clin Diagn Res 2013;7:880–2.

Downloads

Published

31-03-2017

How to Cite

1.
Khan MS, Zeb J, Ahmad A, Zaman A. AETIOLOGICAL FACTORS OF NON-TRAUMATIC DUODENAL PERFORATION. Pak J Phsyiol [Internet]. 2017 Mar. 31 [cited 2024 Mar. 29];13(1):19-21. Available from: https://pjp.pps.org.pk/index.php/PJP/article/view/259