Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke · 2001
[Perforated ulcer].
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Tønnessen T, Carlsen E
Аннотация
BACKGROUND: We wanted to review patients operated for perforated peptic ulcer at Ullevål University Hospital, Oslo, Norway in the period 1992-1997.
MATERIAL AND METHODS: Data from 84 operated patients (43 men) were obtained retrospectively from patient and hospital files. Median age was 69 years (range 20-92 years).
RESULTS: 41 patients had perforated duodenal ulcer and 43 had perforated gastric ulcer (pylorus included). Median time from start of symptoms until admission to hospital was 5 hours (range 2-24 hours; n = 40) and from admission to start of surgery 5 hours (range 1 1/2-48 hours; n = 69). 64 out of 74 patients had pneumoperitoneum on preoperative abdominal X-ray examination. 77 patients were operated with rafi and/or tegmentation of the perforation; six patients with Billroth II or Billroth I; one patient was treated with percutaneous drainage. Median duration of surgery was 68 minutes (range 40-240 minutes). Thirteen patients died in hospital. Post-operative complications were recorded in 30 patients.
INTERPRETATION: Early surgical intervention is important to reduce lethality from ulcus perforatum. A patient with clinical peritonitis and suspected perforated peptic ulcer should be operated without time-consuming examinations.
MATERIAL AND METHODS: Data from 84 operated patients (43 men) were obtained retrospectively from patient and hospital files. Median age was 69 years (range 20-92 years).
RESULTS: 41 patients had perforated duodenal ulcer and 43 had perforated gastric ulcer (pylorus included). Median time from start of symptoms until admission to hospital was 5 hours (range 2-24 hours; n = 40) and from admission to start of surgery 5 hours (range 1 1/2-48 hours; n = 69). 64 out of 74 patients had pneumoperitoneum on preoperative abdominal X-ray examination. 77 patients were operated with rafi and/or tegmentation of the perforation; six patients with Billroth II or Billroth I; one patient was treated with percutaneous drainage. Median duration of surgery was 68 minutes (range 40-240 minutes). Thirteen patients died in hospital. Post-operative complications were recorded in 30 patients.
INTERPRETATION: Early surgical intervention is important to reduce lethality from ulcus perforatum. A patient with clinical peritonitis and suspected perforated peptic ulcer should be operated without time-consuming examinations.