Abstract

LOPEZ RODRIGUEZ, Pedro et al. Postoperative evaluation of patients operated on perforated gastro-duodenal ulcer. Rev Cubana Cir [online]. 2013, vol.52, n.3, pp.183-193. ISSN 0034-7493.

Introduction: Perforated peptic gastroduodenal ulcer represents the most frequent and serious complication after hemorrhage. It occurred in 2 to 5 % of patients diagnosed as peptic ulcer and the main symptoms are caused by the gastroduodenal content spilled over the peritoneal cavity. Objective: To assess the recovery of patients operated on from perforated gastroduodenal ulcer at emergency setting. Methods: Prospective, observational and descriptive study carried out from January 2005 through December 2011. The universe of study was all the patients operated on from perforated gastroduodenal ulcer in "Enrique Cabrera" general teaching hospital's general surgery service in this period. Data were collected in forms, which were processed and analyzed by using Microsoft Office Excel 2007. The results were provided in tables and graphs; summary statistics, absolute and relative distribution for quantitative variables and arithmetic median for the quantitative ones were the statistical techniques used. Results: Men over 60 years old were the main group of patients with this pathology( 42.2 %). The highest incidence rate was found in males (88 %).Toxic habits like coffee plus cigar, and coffee alone were the most frequent, accounting for 23.1 % each. All the patients complained of acute epigastric pain. Chest Rx on standing position was the most used study to confirm the suspected diagnosis. Radiological pneumoperitoneum was evident in 77 % of patients. Duodenal ulcer was the main location of perforation (19 patients). Suture and epiploplasty were performed as emergency treatment in 15 patients (57.7 %). Surgical wound dehiscence was the most common complication. One patient died from bronchopneumonia during the postoperative phase. Conclusions: Patients aged over 60 and males represented the highest number with diagnosis of perforated gastroduodenal ulcer. The most frequent location was duodenum. Epipoplasty and suture were the main therapeutic methods. Suture dehiscence was the most observed complication in this group.

Keywords : peptic ulcer; epiploplasty and suture; piloroplasty and vagotomy.

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