For reasons not yet clear, the incidence of peptic ulcer and of ulcer perforation has decreased in the past two decades (1,2). The exact mechanism and precipitating factors of perforation are still matters of speculation. The reported mortality rate for gastroduodenal ulcer perforation ranges from 5–24% (3,4). Factors significantly contributing to mortality are the age of the patient, the site of perforation, concurrent medical diseases, and the duration between perforation and treatment (4,5). Of the above, the surgeon can influence only the duration between perforation and treatment through early diagnosis and prompt treatment; mortality is 3.7% when the interval is less than 12 hours, but increases to 20% when the interval is greater than 12 hours (5). This fact amply illustrates the benefits of early diagnosis and treatment.
KeywordsNonoperative Treatment Drainage Procedure Gastric Outlet Obstruction Perforated Peptic Ulcer Perforated Ulcer
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- 4.Kozoll DD, Meyer KA (1960) General factors influencing the incidence and mortality of acute perforated gastroduodenal ulcers. Surg Gynecol Obstet III: 607Google Scholar
- 5.Nimanich GJ, Nicoloff DM (1970) Perforated duodenal ulcer; long-term followup. Surgery 67: 727Google Scholar
- 8.Coutsoftides T, Himal HS (1976) Perforated gastroduodenal ulcers. Factors affecting morbidity and mortality and the role of definitive surgery. Am J Surg 132: 575Google Scholar
- 10.Graham RR (1937) The treatment of perforated duodenal ulcers. Surg Gynecol Obstet 64: 235Google Scholar
- 11.Jordan GL, DeBakey ME, Cooley DA (1963) The role of resective therapy in the management of acute gastroduodenal perforation. Am J Surg 105:3%Google Scholar