Surgical audit of peptic perforation among Scheduled Tribe patients attending Bankura Sammilani Medical College and Hospital, India
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
Despite medical advances, duodenal ulcer perforation remains a surgical emergency. A prospective observational study was conducted from January 2013 to October 2014 involving 100 Tribal patients with suspected perforated peptic ulcer (PPU) admitted in department of Surgery, Bankura Sammilani Medical College & Hospital (BSMCH) aiming to assess preoperative risk factors and find out therapeutic outcome with its determinants. Data were collected via interview, clinical examination and necessary investigations using predesigned proforma. Maximum (47.0%) patients belonged to 40-60 years age group with 10.1: 1 male- female ratio. One third, 69% and 36% participants were addicted to alcohol, tobacco smoking and using NSAID, respectively. One fourth (26%) had one or more co-morbidities. Around one third attended BSMCH after one day of onset of symptoms. On admission, pain/tenderness and free fluid in abdomen and gas under diaphragm were almost universal. Obliterated liver dullness, muscle rigidity, diarrhea/ constipation/distention and dehydration were present in more than 2/3rd of patients. Ten percent had high Boey’s score. Majority (46%) of perforation was in range of 0.5cm to 1.0cm. Ninety four and three percent were treated by Graham omental patch surgery and conservative management. Lung infection was the commonest post-operative complication suffered by 35%. Overall mortality was 3.0% and found higher among patients aged >60 years, managed conservatively, had co-morbidities, sustained larger ulcer size with higher Boey’s score and underwent surgical methods other than Graham’s omental repair. The study results would help treating physicians in choosing therapy and in preventing acid peptic disease by reducing risk factors.
Authors and Affiliations
Ramkrishna Mandal, Sampurnananda Jha, Tanushree Mandal, Dibakar Haldar, Suman Singh, Abhik Sinha
Keywords
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- EP ID EP375534
- DOI 10.9790/0853-1706011421.
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