Gedala Sridhar1, Savalam Bujjitha Rathna Kishore2, Gayathri Kolagatla3, T. Narasimha Sai Kiran4
There is presently a widespread use of gastric antisecretory agents and eradication therapy, but the incidence of perforated peptic ulcer has changed little. Nowadays, however, there has been a considerable change in the epidemiology of perforated peptic ulcer in the Western world over the last two decades. This may be because of the fact that previously most patients were middle aged in the western world. This was not long back. In fact this condition was there two decades back with a ratio of 2:1 of male: female. With time, there has been a steady increase in the age of the patients suffering from this complication and an increase in the number of females, such that perforations now occur most commonly in elderly female patients. But in India most of the perforations occur in males. This may be due to consumption of alcohol and smoking habit that is commonly seen in the male counterpart. Non-steroidal anti-inflammatory drugs, especially aspirin appears to be responsible for most of these perforations. A sincere effort has been put in this study to understand and help a surgeon to identify the cases of gastric perforations and act immediately to ensure the safety of the patient before any tragedy occurs.
The study was done in fifty cases that were admitted in the Andhra Medical College, Visakhapatnam, Andhra Pradesh from 01-04-2015 to 29-10-2015.
Out of this fifty, twenty five were female and twenty five were male.
The demographic and other details were taken from the patient’s relatives or from the patient when the condition of the patient was stabilised.
In the present study, majority of the cases were seen from the month of June to September. This may be pointing to the fact that majority of the peptic ulcers are seen in rainy season. Majority of the cases were admitted within six hours and majority of them were females. The signs which were significantly associated with the disease and were almost equally seen in both the sexes were pain, vomiting, fever and abdominal distension.
Drinking and smoking were strongly associated with the disease. Females were not involved in both. Dehydration, distension, tenderness and guarding were the signs that were significantly associated with the disease. Majority of the patients were having O blood group. Radiography was confirmatory as the gas bubbles were seen under the diaphragm in 100% of the cases. The post-operative complications were significantly lower except in patients with larger perforations.
The clinical analysis of gastric perforations has been strongly associated to the life style modifications. Drinking and smoking has been directly related. The genetic causes also play a role. This may be understood by the fact that majority had O blood group.
Proper diagnosis can be made by using the signs and symptoms that has been associated with the disease. This study has a lot of future. Study can be made in different regions of the country to properly understand the underlying plethora of causes that determine this horrible disease.