Perforated gastric ulcers. A retrospective study of 32 patients.

During the last 6 years the authors have treated 99 patients with perforated peptic ulcers. Sixty-six patients had perforated pyloro-duodenal ulcers, while 32 patients were treated for perforated gastric ulcers, a ratio of 2:1. This article deals with the gastric ulcers treated by a surgical unit in an urban, 600-bed multidisciplinary hospital. The mean age of the patients was 58.7 years. In 71.8 per cent of the patients, the perforation was the first major manifestation of the ulcer disease. Seven patients (21.8%), all in the high-risk group according to the criteria of Boey et al. died. There was no death among the low-risk patient group. Eleven patients, all high-risk, had excision and/or biopsy of the ulcer followed by simple closure; three of these patients died (27.2%). Twenty patients, of whom seven were in the high-risk group, underwent gastrectomy; three deaths occurred (15%). The authors conclude that the underlying general health of the patient is a major determinant of the outcome following gastric ulcer perforation.