ASSESSMENT OF THE MAGNITUDE, ASSOCIATED FACTORS AND OUTCOME OF PERFORATED PEPTIC ULCER DISEASE AMONG PATIENTS PRESENTED WITH SURGICAL ACUTE ABDOMEN AT RAS DESTA HOSPITAL IN ADDIS ABABA

Abstract

ABSTRACT BACKGROUND: - Peptic ulcer perforation is a life threatening complication of peptic ulcer disease occurring in about 2–14% of cases of peptic ulcer disease. Perforated peptic ulcer is a surgical emergency and is associated with short-term mortality in up to 30% of patients and morbidity in up to 50%. Perforation is one of the commonest causes of emergency hospitalization and surgery in peptic ulcer disease and it is also one of the commonest causes of acute abdomen. There is a scarcity of high-quality studies about the condition that results in limitation of the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are common causes, there is demographic differences and variation in mortality between countries, as well as among different setup within the same country. OBJECTIVE: - To assess the magnitude, risk factors and outcome of perforated peptic ulcer among patients who presented with surgical acute abdomen at Ras Desta Damtew Memorial Hospital over a period of 2 years (October 2015 to 2016). METHODS: - A hospital based descriptive type of cross sectional study was conducted from June 12 to 18 focusing on two years retrospective record review of the surgical patients who were admitted from October 2015 to August 2016. Medical records of patients were used. The SPSS version 20 was used to analyze the data. RESULTS: - There were a total of 606 admissions with an assessment of surgical acute abdomen during the study period. Of the total admissions, 66 of them were found to have PPUD making the prevalence of PPUD 11 %. The study involved analysis of 66 cases of PPUD. 47 % of cases were found in the age group of 40-60 years with a M: F ratio of 1.6:1. 65 % of cases had previous history of dyspepsia while 56 % had family history of similar illness (dyspepsia). 64% of cases were discharged without complication while the most common post operative complication was wound infection followed by sepsis. Based on the finding of this study, age was found to have significant association with complication with a level of significance of 0.017. CONCLUSION Perforated peptic ulcer was one of the most common causes (accounting for ~11%) of acute abdomen. Based on the findings of this research most patients having PPU was the males, office workers, those found in the age group of 40-60 years and those who have previous history and family history of clinical peptic ulcer disease. Wound infection was the most common post operative complication. Based on the finding of this study, age was found to have significant association with complication with a level of significance of 0.017.