Peptic duodenal perforation-an audit

ABSTRACT

This study was carried out from November 1996 to August 1998 in the Surgery Department of Sandeman Provincial Teaching Hospital, Quetta, on a total of 40 patients hospitalized with peptic duodenal perforation. The major- of the patients [92.5%] was below 50 years of age with peak incidence in the third decade of life [32.5%]. The mean standard deviation of patients' age was 31.4 ' 13.3 years and male to female ratio was 12.31. The incidence among males was 9 per 1000 patients and in female 1 per 1000 patients. The overall incidence was 7 per 1000 patients. The majority of the patients [82.5%] came within 48 hours. The median duration of perforation was 40 hours. In all the patients there was a single perforation at the first part of duodenum on anterior surface. The median size was 4.5 mm. Simple closure with viable omental patch repair was performed in all the cases. Patients with longer duration of perforation had increase morbidity to wound and respiratory tract infections [P<0.001 by Chi sq test]. Most of the patient remain admitted for less than 10 days. Their median hospital stay was 14.5 days with minimum stay of 6 days and maximum stay of 32 days. The overall mortality was [7.5%] attributed to old age, leakage from repair site and associated medical illnesses. The duration of perforation had no effect on mortality in this study