Clinical presentation and outcome of perforated peptic ulcer patients at Dr. Soetomo Hospital Surabaya, Indonesia

Erwin Kurniawan; Edwin  Danardono

doi:10.15562/bmj.v12i3.4745

Clinical presentation and outcome of perforated peptic ulcer patients at Dr. Soetomo Hospital Surabaya, Indonesia

Erwin Kurniawan ,

Edwin Danardono ,

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DOI: https://doi.org/10.15562/bmj.v12i3.4745 |
Published: 2023-08-30

Abstract

Background: Perforated peptic ulcer often occurs in peptic ulcer disease. Identifying the clinical presentation before any operation is important to predict mortality and decision-making about management perforated peptic ulcers. Until to date, there is no report data of perforated peptic ulcer

characteristics at Dr Soetomo Hospital Surabaya.

Methods: This is a non-experimental study with descriptive retrospective design. Data were collected retrospectively from medical records all consecutive patients with diagnosis of perforated peptic ulcer at Dr. Soetomo Hospital 2020 - 2022.

Results: For three years, 97 patients were treated with perforated peptic ulcers with a high mortality of 48.5%. Patients were 67% male and 33% female with an average age of 61.4 ± 12.1 years old. There are two options for source control management: external drainage in patients with a Boey score of 3 with a mortality rate of 78.9% and definitive laparotomy repair perforation with a mortality rate of 28.8%. Patients with hemodynamic instability and sepsis have a high mortality rate. The most comorbid patients with perforated peptic ulcer are peripheral vascular disease, endocrine disorders,and lung disease.

Conclusion: Patients with perforated peptic ulcers at Dr. Soetomo Hospital have a high mortality rate. Treatment can be in the form of definitive surgery and external drainage. However, external drainage has a high mortality rate.

References

Halpern GM. Peptic Ulcer Disease and Helicobacter Pylori. Adv Med with Food Nutr Second Ed. 2012;229–43.
Chung KT, Shelat VG. Perforated peptic ulcer - an update. World J Gastrointest Surg. 2017;9(1):1-12.
Koto K, Asrul A, A M. Characteristic of Gastric Perforation Type and The Histopathology at Haji Adam Malik General Hospital Medan-Indonesia. Bali Med J. 2016;5(1):166-8. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/325.
Anbalakan K, Chua D, Pandya GJ, Shelat VG. Five-year experience in management of perforated peptic ulcer and validation of common mortality risk prediction models - Are existing models sufficient? A retrospective cohort study. Int J Surg. 2015;14:38–44.
Kim JM, Jeong SH, Lee YJ, Park ST, Choi SK, Hong SC, et al. Analysis of risk factors for postoperative morbidity in perforated peptic ulcer. J Gastric Cancer. 2012;12(1):26–35.
Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, Mérisier ED, El-Halabi S, Farmer PE, Gawande A, Gillies R, Greenberg SL, Grimes CE, Gruen RL, Ismail EA, Kamara TB, Lavy C, Lundeg G, Mkandawire NC, Raykar NP, Riesel JN, Rodas E, Rose J, Roy N, Shrime MG, Sullivan R, Verguet S, Watters D, Weiser TG, Wilson IH, Yamey G, Yip W. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569-624.
Tamuntuan YC, Sapan HB, Panelewen J. Perbandingan mortalitas antara tindakan drainase perkutan dan laparotomi eksplorasi pada pasien perforasi ulkus peptikum. J Biomedik. 2016;8(2):44–51.
Venkatesan S, Myles PR, Manning HJ, Mozid AM, Andersson C, Jørgensen ME, et al. Cohort study of preoperative blood pressure and risk of 30-day mortality after elective non-cardiac surgery. Br J Anaesth. 2017;119(1):65–77.
Thompson K, Venkatesh B, Finfer S. Sepsis and septic shock: current approaches to management. Intern Med J. 2019;49(2):160–70.
Luo X, Li L, Ou S, Zeng Z, Chen Z. Risk Factors for Mortality in Abdominal Infection Patients in ICU: A Retrospective Study From 2011 to 2018. Front Med. 2022;9:6–11.
Engeland CG. Mucosal Wound Healing. Arch Surg. 2006;141(12):1193.
Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-zidan FM, El A, et al. WSES / GAIS / SIS-E / WSIS / AAST global clinical pathways for patients with intra-abdominal infections. 2021;8:1–48.
Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med. 2008;34(1):17–60.
Mouncey PR, Osborn TM, Power GS, Harrison DA, Sadique MZ, Grieve RD, et al. Trial of Early, Goal-Directed Resuscitation for Septic Shock. N Engl J Med. 2015;372(14):1301–11.

[1] Halpern GM. Peptic Ulcer Disease and Helicobacter Pylori. Adv Med with Food Nutr Second Ed. 2012;229–43.

[2] Chung KT, Shelat VG. Perforated peptic ulcer - an update. World J Gastrointest Surg. 2017;9(1):1-12.

[3] Koto K, Asrul A, A M. Characteristic of Gastric Perforation Type and The Histopathology at Haji Adam Malik General Hospital Medan-Indonesia. Bali Med J. 2016;5(1):166-8. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/325.

[4] Anbalakan K, Chua D, Pandya GJ, Shelat VG. Five-year experience in management of perforated peptic ulcer and validation of common mortality risk prediction models - Are existing models sufficient? A retrospective cohort study. Int J Surg. 2015;14:38–44.

[5] Kim JM, Jeong SH, Lee YJ, Park ST, Choi SK, Hong SC, et al. Analysis of risk factors for postoperative morbidity in perforated peptic ulcer. J Gastric Cancer. 2012;12(1):26–35.

[6] Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, Mérisier ED, El-Halabi S, Farmer PE, Gawande A, Gillies R, Greenberg SL, Grimes CE, Gruen RL, Ismail EA, Kamara TB, Lavy C, Lundeg G, Mkandawire NC, Raykar NP, Riesel JN, Rodas E, Rose J, Roy N, Shrime MG, Sullivan R, Verguet S, Watters D, Weiser TG, Wilson IH, Yamey G, Yip W. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569-624.

[7] Tamuntuan YC, Sapan HB, Panelewen J. Perbandingan mortalitas antara tindakan drainase perkutan dan laparotomi eksplorasi pada pasien perforasi ulkus peptikum. J Biomedik. 2016;8(2):44–51.

[8] Venkatesan S, Myles PR, Manning HJ, Mozid AM, Andersson C, Jørgensen ME, et al. Cohort study of preoperative blood pressure and risk of 30-day mortality after elective non-cardiac surgery. Br J Anaesth. 2017;119(1):65–77.

[9] Thompson K, Venkatesh B, Finfer S. Sepsis and septic shock: current approaches to management. Intern Med J. 2019;49(2):160–70.

[10] Luo X, Li L, Ou S, Zeng Z, Chen Z. Risk Factors for Mortality in Abdominal Infection Patients in ICU: A Retrospective Study From 2011 to 2018. Front Med. 2022;9:6–11.

[11] Engeland CG. Mucosal Wound Healing. Arch Surg. 2006;141(12):1193.

[12] Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-zidan FM, El A, et al. WSES / GAIS / SIS-E / WSIS / AAST global clinical pathways for patients with intra-abdominal infections. 2021;8:1–48.

[13] Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med. 2008;34(1):17–60.

[14] Mouncey PR, Osborn TM, Power GS, Harrison DA, Sadique MZ, Grieve RD, et al. Trial of Early, Goal-Directed Resuscitation for Septic Shock. N Engl J Med. 2015;372(14):1301–11.

Clinical presentation and outcome of perforated peptic ulcer patients at Dr. Soetomo Hospital Surabaya, Indonesia

Abstract

References

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