Pattern of Presentation and Outcome of Perforated Pud Patients Who Underwent Emergency Surgical Operations At Jumc Between Hidar 21, 2008 And Hidar, 22, 2009 E.C

Abstract

Background Surgical acute abdomen is the commonly encountered emergencies in the practice of general surgery and for which emergency surgical operations are commonly performed. Peptic ulcer disease represents a worldwide health problem because of its high morbidity, mortality & economic loss. Perforated peptic ulcer is one of the serious complications of peptic ulcers with potential of resulting in grave outcomes. Despite this fact we have got only few published reports on this big health burden in our country so far. Hence this study will be conducted to evaluate the clinical presentation, management and outcome of patients with peptic ulcer perforation in our setting and to identify predictors of outcome of these patients. Objective To study clinical presentation pattern & Outcome of Perforated PUD Patients who underwent emergency Surgical Operations in JUMC between Hidar 21,2008 to Hidar 22,2009 E.C. Method A one year hospital based retrospective study, in JUMC, Jimma, Ethiopia from Hidar 21,2008 to Hidar 22,2009 E.C, was conducted using data from patient cards, admission records, operative log books and morbidity & mortality charts at JUMC. Data was entered into and analyzed using SPSS windows program version 24. Odds ratio and 95% CI were calculated using the chi-square test and P < 0.05 was considered statistically significant. Results Out of 40 cases operated for PPU in the study period, charts of 32 cases were analyzed making the retrieval rate 80%. 90.6% were males & 75% are under 40 years of age. Previous history of PUD & cigarette smoking were documented in 62.5% & 15.62% respectively. The post-operative complication rate is 34.4% & overall mortality of the study is 21.9%. Factors found to be significantly associated with increased complications were age above 40 (p=0.027) & treatment delay > 48 hours (p=0.016). Whereas mortality was increased by treatment delay (p=0.040) & shock at presentation (p=0.039). Conclusion & Recommendation Perforated peptic ulcers as we have noted from our study is a disease of the young & males unlike the figures from the developed nations. PPU has high rates of overall morbidity & mortality. Early presentation of patients to surgical care facilities may reduce the overall morbidity and mortality