A RETROSPECTIVE STUDY: MANAGEMENT OF LARGE DUODENAL ULCER PERFORATION PERITONITIS AT PATNA MEDICAL COLLEGE & HOSPITAL, PATNA

DR. SUSHIL KUMAR; DR. MD ASJAD KARIM BAKHTEYAR; DR. BINOD KUMAR; MD. HABIBULLAH ANSARI

Volume : VIII, Issue : II, February - 2019

A RETROSPECTIVE STUDY: MANAGEMENT OF LARGE DUODENAL ULCER PERFORATION PERITONITIS AT PATNA MEDICAL COLLEGE & HOSPITAL, PATNA

Dr. Sushil Kumar, Dr. Md Asjad Karim Bakhteyar, Dr. Binod Kumar, Md. Habibullah Ansari

Abstract :

Aim: Aim of this study is to define, incidence, different procedure of management and complication related to large duodenal ulcer perforation peritonitis. Materials and Methods: A retrospective study on 108 cases of duodenal ulcer perforation that underwent emergency laparotomy at surgical emergency of PMCH, Patna during the period of December 2015 to November 2018. All these patients were classified into 3 groups based on size of perforation: Group A: Small perforation: less than 1 cm in diameter Group B: Large perforation: when the perforation was more than 1 cm but less than 3 cms Group C: Giant perforation: when the perforation was more than 3 cms. These groups of patients were then compared with each other in regard to the patient particulars, surgery performed and the outcome in all these 3 groups. Results & conclusion: Patients had a significantly higher incidence of leak, morbidity and mortality in giant perforation as compared to those with smaller perforations. It was concluded that in 27 patients were identified to have duodenal ulcer perforations more than 1 cm in size. These group A with small perforation it was easy to mange with low morbidity & mortality where as in group B with large perforation was less common but primary repair with omental patch closure and feeding jejunostomy given the best results while The last group C with perforation more than 3cm was extremely rare & most difficult to manage with high rate of complication.