Patterns and Seasonal Variations of Perforated Peptic Ulcer Disease: Experience from Ethiopia

Abstract

Background: Perforated Peptic Ulcer Disease occurs in 2-10% of patients with ulcer disease and its principal treatment is surgical. Objective: To describe the socio-demographics of the patients, seasonal variation in its incidence, modes of surgical management and outcome of patients. Methods: This was a retrospective study on patients operated for acute perforated peptic ulcer at the Minilik II Memorial Referral Hospital, Ethiopia over a three-year period. Results: Eighty-seven patients were studied, 75 (86.2%) males were predominant. Current use of Chat and Cigarettes were reported by 44 (50.5%) and 41 (47.1%) of patients. Significant number of patients 39 (44.8 %) were operated during the Ethiopian rainy Season of July-September. The commonest presenting symptoms were sudden onset epigastric pain that become very severe in 83 (95.5%). Perforation of the anterior aspect of first part of the duodenum is the most common intra-operative findings in 88.7% (77) of cases and Pedicled omental patch repair after Cellan- Jones was performed in 83 (95.4%) of the patients. Atotal of 42 complications occurred in 20 (22.9%) of the patients, the commonest being wound infection. Ten (11.4%) underwent re-laparotomy. Nine patients (10.3%) died. Conclusion: This study has shown that perforated PUD affects young males who are smokers, alcohol users and khat chewers. It is also very common during the rainy Ethiopian months. We recommend further studies to study the interplay of these risk factors in the pathogenesis of perforations, especially their interaction with H.Pyloriinfection.

Key words: Perforated PUD, Omental Patch, Seasonal variation, risk factors,