[Perforated duodenal ulcer in high risk patients].

AIM: To improve the outcomes in patients with perforated duodenal ulcers.

MATERIAL AND

METHODS

Cohort study included 456 patients with perforated duodenal ulcer. High risk of mortality was determined in 9% of patients (n=40) considering Boey diagnostic criteria (1982, 1987). There were 19 women and 21 men aged 59±2.8 years.

RESULTS

Perforated duodenal ulcer was followed by overall mortality near 3.8%. In high risk group this value was 17.5% (7 out of 40 patients) while expected mortality was 45.5-100% in these patients in view of Boey criteria. The main causes of death were multiple organ failure, pulmonary embolism and acute myocardial infarction.

CONCLUSION

Minimally invasive surgery including step-by-step procedures (mini-laparotomy, laparoscopy and navigation) are the key to improve the outcomes in patients with perforated duodenal ulcer.