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TO KNOW THE CONSERVATIVE AND SURGICAL TREATMENT OUTCOMES OF PEPTIC ULCERS

Dr Aamir Saeed, Dr Rashid Ashraf, Dr Aeman Shafique

Background and objectives: Perforation is an important life-threatening complication of peptic ulcer. The traditional treatment is surgery for this perforation. The surgery results are outstanding, but have high mortality and morbidity. In 1935, Wangensteen and in 1946 Taylor showed that a non-surgical treatment was effective and safe in particular patients because omentum and nearby organs cover the peptic perforations were usually self-closed. We conducted a prospective study to determine the outcomes and evaluate the probability of surgical and non-surgical treatment of perforated peptic ulcers. Study Design: A prospective case series study. Place and Duration: In the Surgical Unit II of Services Hospital Lahore for one-year duration from March 2018 to March 2019. Methods: We investigated fifty clinical diagnosed perforated peptic ulcer cases. The criteria of inclusion were stable hemodynamic status, age -20-70 years, and less than 12 hours before diagnosed clinically of perforation by X-ray test and / or CT of a pneumoperitoneum. Conservative treatment entailed of nothing given with the mouth, intravenous fluids, nasogastric suction, intravenous omeprazole and intravenous antibiotics. Results: Forty-one (82%) of the fifty patients responded well, 9 of them did not improve and required emergency laparotomy. Complications developed in 11 of 41 patients in the successful group, which were successfully managed and did not extend stay in hospital. Conservative treatment did not significantly rise morbidity. Conclusion: We concluded that for perforated peptic ulcer conservative treatment can be safe in particular patients as long as appropriate admission criteria and guidelines are followed. Keywords: Perforation, peptic ulcer, intravenous fluids, intravenous antibiotics, nasogastric suction.

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