The Perforation-Operation time Interval; An Important Mortality Indicator in Peptic Ulcer Perforation.

OBJECTIVE

To find out the significance of the Perforation-Operation Interval (POI) with respect to an early prognosis, in patients with peritonitis which is caused by peptic ulcer perforation.

METHODS

Case series. Place and Duration of the Study: Department of General Surgery, Konaseema Institute of Medical Sciences and RF Amalapuram, Andhra Pradesh, India from 2008-2011.

METHODS

This study included 150 patients with generalized peritonitis, who were diagnosed to have Perforated Peptic Ulcers (PPUs). The diagnosis of the PPUs was established on the basis of the history , the clinical examination and the radiological findings. 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 150 patients 134 were males and 16 were females, with a male : female ratio of 9:1. Their ages ranged between 25-70 years. Out of the 150 patients, 65 patients (43.3%) presented within 24 hours of the onset of severe abdominal pain (Group A), 27 patients (18%) presented between 24-48 hours of the onset of severe abdominal pain (Group B) and 58 patients (38.6%) presented after 48 hours. There was no mortality in Group A and the morbidity was more in Group B and Group C. There were 15 deaths in Group C.

CONCLUSIONS

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.