Perforated peptic ulcer a review of 36 cases

To evaluate the epidemiology of peptic ulcer perforation in Armed Forces and further management / outcome of the patients. Data of 36 patients with perforated peptic ulcer collected. This data was analyzed on SPSS 13. CMH Rawalpindi from Jan 1979 to July 1981, Jan 1985 to Dec 1987 and Jan 2001 to Dec 2003. Out of 36 patients 35 were male and only one was female. Twenty four [67%] were between 31-50 years. No past history was taken from eight [22%] patients. Thirty four [94%] patients presented with duodenal perforation. Twenty patients [55%] had rigidity all over abdomen and peristalsis were present in ten [28%] patients who reported within twelve hours. Seventy eight [78%] were diagnosed by history and simple radiological examination. All the patients were treated by laparotomy [simple closure with omental patch]. Post operative complications occur in ten [28%] patients and mortality rate was 8%. Predominantly the peptic ulcer perforation occurs between 30-50 years of age. The incidence reduces with succeeding years of study. Post operative complications were less in younger age group .Early diagnosis can be made easily by taking good history and performing simple radiological examination

Gastrointestinal Tract Perforation: MDCT Findings according to the Perforation Sites

Our objective is to describe the characteristic CT findings of gastrointestinal (GI) tract perforations at various levels of the gastrointestinal system. It is beneficial to localize the perforation site as well as to diagnose the presence of bowel perforation for planning the correct surgery. CT has been established as the most valuable imaging technique for identifying the presence, site and cause of the GI tract perforation. The amount and location of extraluminal free air usually differ among various perforation sites. Further, CT findings such as discontinuity of the bowel wall and concentrated free air bubbles in close proximity to the bowel wall can help predict the perforation site. Multidetector CT with the multiplanar reformation images has improved the accuracy of CT for predicting the perforation sites.