The role of surgery for peptic ulcer in eastern Ethiopia

Abstract

This was a retrospective study of 90 patients operated on for peptic ulcer disease (PUD) in Karamara Hospital, Ethiopia, between 1st April 1994 and 31st March 1995. Seventy-eight patients were admitted with a preliminary diagnosis of gastric outlet obstruction secondary to PUD (86%) and 12 as intractable PUD.

The diagnosis was based solely on the history and physical examination as neither barium meal fluoroscopy nor endoscopy were available. At operation a scarred duodenum and a large stomach were found in 71 patients (79%), an active ulcer without stenosis in 10, and a stenosed duodenum with mesenteric tubercles in two. In three, there were no abnormal findings.

There were four patients under 20 years old and seven over 60. The  peak-age was 39 years. There were 88 males and only two females. Truncal vagotomy with gastrojejunostomy was the operation performed for 84 cases of PUD. An accurate diagnosis had been made by clinical examination in 82 out of 90 patients. Twenty-one patients (23%) suffered early postoperative complications with pneumonia as the commonest (7). The only two 'ulcer related complications' were one case of upper gastrointestinal bleeding and intractable postoperative vomiting in one patient.

It is interesting that, during the twelve months surveyed, no patients presented with either bleeding or with perforation. No late complications or deaths occurred during the study period or the following three months.

Keywords: peptic ulcer, Ethiopia