Résumé
Background: Peptic ulcer disease (PUD) is a common disorder that affects millions of individuals each year. PUD has a major impact on our health-care system by accounting for roughly 10% of medical costs for digestive diseases. Overall, peptic ulcer mortality and hospitalization rates have declined for the past two decades, but complications such as peptic ulcer perforation and bleeding remain a substantial health-care problem. Materials and Methods: It was a prospective 1-year study conducted in all cases of peptic perforation admitted in surgical wards during the study period August 2013-July 2014. On admission, every patient was interrogated about name, age, sex, address, occupation, religion, and residence. All patients suspected of peptic perforation with symptoms of the sudden onset of epigastric pain in abdomen, distention of abdomen, constipation, and vomiting were admitted to surgery ward from the outpatient department or transferred from other wards. Their findings were recorded in a pro forma and master chart. The information obtained was tabulated and analyzed. Results: Incidence of peptic perforation was 1.65% of all surgical admissions. It was 6.63% of total case of acute abdomen and 50.17% of total case of perforation peritonitis. A maximum number of peptic perforation cases was found in age group 51-60 years (24.67%). Conclusion: Perforation of the peptic ulcer is due to the persistence of causative factors of peptic ulceration with a decrease in mucosal resistance due to injudicious use of corticosteroids, decreased immunity, malnutrition, delay in hospitalization due to initial treatment by homemade medicines and abdominal massage further complicates the perforation in this region. Peptic perforation is diagnosed on clinical grounds and abdominal X-ray easily, yet due to delayed hospitalization and time consumed in resuscitation of the patient affects the outcome of standard surgical procedure.
Résumé
Background: Geriatric patients having surgical problems are more vulnerable for devastating resulting in higher morbidity and mortality rates. Because of comorbid medical illness and low immunity power management of surgical problems in a geriatric patient at the initial stage is necessary. Materials and Methods: It was a prospective 1 year study. On admission, every patient was interrogated about name, age, sex, address, occupation, religion, and residence. They were also inquired for chief complaints with duration, past history, drug history, personal history, and family history. Their findings were recorded in a pro forma and master chart. The information obtained was tabulated and analyzed. Results: Incidence of surgical problems in the geriatric patient was 19.18% out of total surgical ward admission. The majority of patients were male (70.35%) with male:female ratio of 2.4:1. The majority of patients were in age group 60-64 years (31.89%). A number of patients in the age group 80 years and above was also significant (15.28%). The eldest patient was 102-year-old male. The majority of patients were from a rural area (83.39%) followed by urban (16.61%). The majority of elderly patients admitted were suffering from medical illness associated with surgical problems most common being anemia (28.79%) followed by diabetes mellitus (19.54%), hypertension (18.96%), and tuberculosis (9.71%). The majority of elderly patients in both sexes were suffering from gastrointestinal tract disorders (28.79%). In males, the second common system involved was genitourinary system (24.67%) followed by skin and soft tissue lesions (18.87%), central nervous system (8.98%), and hernia (8.66%). In females, the second common system involved was skin and soft tissue lesions (21.12%) followed by hepatobiliary system (17.44%), central nervous system (11.43%), and breast lesions (8.72%). Conclusion: For healthy old age life, it is advised to take balanced diet and do physical activity for prevention of functional decline, increased survival and also avoids smoking, tobacco chewing, and alcoholism to reduce cardiovascular and other diseases risks.