Prevalence of H.pylori in Perforated Peptic Ulcer Disease in Saint Paul’s Hospital Millennium Medical College: Retrospective Study

Abstract

Abstract Objective To determine Prevalence of H.pylori in Perforated Peptic Ulcer Disease. Method and Materials Between January 9, 2013 and February 7, 2018, all patients operated for perforated peptic ulcer disease were recruited retrospectively, from patient’s medical records, operation room registration books and computer registration. Demographic data, medical history, past history of peptic ulcer, smoking, alcohol intake, use of NSAIDs, use of chat were recorded using pre-prepared data collecting format. The study included patients who have H.pylori test results attached to the medical records. All patients were treated with exploratory laparatomy and Graham’s omental patch done for the majority of them. Immediately after surgery, intravenous cimetidine /omeprazole were initiated. Majority of patients were given eradication therapy regardless of their H.pylori status. Result During the 60 months period a total number of 141 patients operated for perforated peptic ulcer disease were recruited and only 46 patients were used for the analysis, since the others were excluded. Their mean age was 34.11 years (Range 17-74 years), thirty nine (84.8%) were male while only 7 (15.2%) are female. Out of 46 patients , 43 ( 93.5% ) patients had perforated duodenal ulcer while only 1 (2.2 % ) patient had perforated gastric ulcer and other 2 ( 4.3 % ) patients found to have sealed duodenal perforation. Thirty two (69.6%) patients had history of chronic dyspepsia. Five patients (10.9%) were smokers. Six patients (13%) were alcoholic. Seven patients (15.2%) were chat chewer. 10 (21.7%) patients had positive stool antigen test. When we see serology test result, 11(23.9 %) patient had positive result. Overall, 19 (41.3%) patients had positive result regardless of types of test used. Conclusion This study showed relatively low prevalence of H.pylori (41.3%) and therefore , a cost effective initial approach is to test for H.pylori and treat the infection if the test if positive. If H.pylori test is negative, empiric therapy with acid suppressant or prokinetic agent recommended. Key words: Perforated peptic ulcer, Peptic ulcer, Helicobacter Pylori, Eradication therapy