Title: Management of Peptic Ulcer Perforation is there A Role for Conservative Management? A Research Study at a Tertiary Care Center in North East India

Authors: Sapam Opendro Singh, Saswade Kalpesh, Manu Maheendran, Lalsangzuala Tochhawang, Th. Sudhir Chandra Singh, M. Birkumar Sharma

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i2.69

Abstract

Background – Conservative treatment of perforated peptic ulcer has documented good results in carefully selected patients with fair general condition. The aim of this study is to determine whether surgery could be avoided in some selected patients with peptic ulcer perforation.

Material and Methods – during the period July 2002-Nov 2012, 68 patients who were treated conservatively forms the study population. Conservative treatment consists of nasogastric aspiration, keeping patient nil per orally, administration of IV antibiotics, fluid supplements, proton pump inhibitor and close monitoring of vital signs and abdominal girth.

Endpoints – Duration of hospital stay

Results –Most of the patients in our study were in age group of 40-70 years (63.24%) with male: female ratio of 38:5.We also noticed that 50 % of patients came to the hospital within 24 hours of onset of symptoms. Median hospital stay was 8.48 days. We had no mortality during our study or follow up period.

Conclusion – Conservative management of peptic ulcer perforation is a safe procedure in selected cases particularly in medically unfit patients for surgery but care should be taken for the possibility of laparotomy anytime.

Key Words – Peptic ulcer, Peptic ulcer perforation, Surgical repair, Conservative management.

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Corresponding Author

Dr Saswade Kalpesh

PG Student, Department of Surgery

Regional Institute of Medical Sciences, Imphal, Manipur, INDIA