Abstract
The results of 136 consecutive patients treated surgically for the acute complications of peptic ulcers between 1990 and 1993 are reviewed. All patients required emergency operation. Among 136 patients, 91 had perforations, 42 hemorrhage, and 3 a penetrated peptic ulcer. The median age was 77 years; 65% were women; and 83% were more than 60 years old. Concurrent disease requiring medical treatment were present in 92 patients; 79 patients (58%) were currently or recently taking antiinflammatory drugs at the time of admission; 66% of the patients had duodenal ulcer. Only 46 patients (34%) had no postoperative complications; pneumonia, arrhythmia, bleeding, and septic complications were the most frequent. The overall mortality was 30%. Sepsis and multiple organ failure was the leading cause of death in most of the patients. It was concluded that elderly individuals using two or more antiinflammatory drugs should be considered potential peptic ulcer patients and should be treated prophylactically with ulcer-healing drugs.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Meisner, S., Sørensen, A., Wille-Jørgensen, P.A.: Peptic ulcer surgery 1976–1978 and 1986–1988. Ugeskr.Læger 155:3828, 1993
Makela, J., Laitinen, S., Kairalouma, M.I.: Complications of peptic ulcer disease before and after the introduction of Hb2-receptor antagonists. Hepatogastroenterology 39:144, 1992
McGuire, H.H., and Horsley, J.S.: Emergency operations for gastric and duodenal ulcers in high risk patients. Ann. Surg. 203:551, 1986
Walt, R., Katchinski, B., Logan, R., Ashley, J., Langman, M.: Rising frequency of ulcer perforation in elderly people in the United Kingdom. Lancet 1:489, 1986
Christensen, A., Bousfield, R., Christensen, J.: Incidence of perforated and bleeding ulcers before and after introduction of Hb2-receptor antagonists. Ann. Surg. 207:4, 1988
Meran, J.G., Wagner, S., Manns, M.: Komplikationen des peptischen ulkus. Wien Med. Wochenschr. 142:183, 1992
Jensen, M.O., Bubrick, M.T., Onstad, G.R., Hitchcock, C.R.: Changes in the surgical treatment of acid peptic disease. Am. Surg. 51:556, 1985
Sonnenberg, A.: Changes in physician visits for gastric and duodenal ulcer in the United States during 1958–1984 as shown by National Disease and Therapeutic Index (NDTI). Dig. Sci. 32:1, 1987
Keating, J., Chandran, H.: Antiinflammatory drugs and emergency surgery for peptic ulcers in the Waikato. N.Z. Med. J. 105:127, 1992
Kulber, D.A., Hartunian, S., Schiller, D., Morgenstern, L.: The current spectrum of peptic ulcer disease in the older age groups. Am. Surg. 56:737, 1990
Pappas, N.T., Debas, H.T.: Complications of peptic ulcer disease: perforation and obstruction. In Gastrointestinal Emergencies, M.B. Taylor et al., editors. Baltimore, Williams & Wilkins, 1992, pp. 83–91
Katz, J.: The course of peptic ulcer disease. Med. Clin. North Am. 75:831, 1991
Boey, J., Choi, S.K.Y., Alagaratnam, T.T., Poon, A.: Risk stratification in perforated duodenal ulcers: a prospective validation of predictive factors. Ann. Surg. 205:22, 1987
Larson, G., Schmidt, T., Gott, J., Bond, S., O’Connor, C.A., Richardson, J.D.: Upper gastrointestinal bleeding; predictors of outcome. Surgery 100:765, 1986
Hunt, P.S.: Bleeding gastroduodenal ulcers; selection of patients for surgery. World J. Surg. 11:289, 1987
Langman, M.J.S., Weil, J., Wainwright, D.H., et al.: Risks of bleeding peptic ulcer associated with individual non-steroid antiinflammatory drugs. Lancet 343:1075, 1994
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bulut, O., Rasmussen, C. & Fischer, A. Acute Surgical Treatment of Complicated Peptic Ulcers with Special Reference to the Elderly. World J. Surg. 20, 574–577 (1996). https://doi.org/10.1007/s002689900089
Published:
Issue Date:
DOI: https://doi.org/10.1007/s002689900089