Perforated Gastroduodenal Ulcers

  • V. I. Sreenivas


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.


Nonoperative Treatment Drainage Procedure Gastric Outlet Obstruction Perforated Peptic Ulcer Perforated Ulcer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Smith MP (1977) Decline in duodenal ulcer surgery. JAMA 237: 987PubMedCrossRefGoogle Scholar
  2. 2.
    MacKay C (1966) Perforated peptic ulcer in the west of Scotland. A survey of 5,343 cases during 1954–63. Br Med J 1: 701PubMedCrossRefGoogle Scholar
  3. 3.
    Seeley SF, Campbell D (1956) Nonoperative treatment of perforated peptic ulcer; a further report (int Abstr). Surg Gynecol Obstet 102: 435PubMedGoogle Scholar
  4. 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. 5.
    Nimanich GJ, Nicoloff DM (1970) Perforated duodenal ulcer; long-term followup. Surgery 67: 727Google Scholar
  6. 6.
    Read RC, Thompson BW (1975) Gastric outlet obstruction after omentopexy for perforated “acute” and “chronic” duodenal ulceration. Am J Surg 130: 682PubMedCrossRefGoogle Scholar
  7. 7.
    Leading article (1976) Perforated duodenal ulcer. Br Med J 2: 489CrossRefGoogle Scholar
  8. 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
  9. 9.
    Kozoll DD, Meyer KA (1962) Laboratory findings in acute perforated gastroduodenal ulcers. Arch Surg 84: 646PubMedCrossRefGoogle Scholar
  10. 10.
    Graham RR (1937) The treatment of perforated duodenal ulcers. Surg Gynecol Obstet 64: 235Google Scholar
  11. 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
  12. 12.
    Sawyers JL, Herrington JL (1977) Perforated duodenal ulcer managed by proximal gastric vagotomy and suture plication. Ann Surg 185: 656PubMedCrossRefGoogle Scholar
  13. 13.
    Hinshaw DB, Pierandozzi JS, Thompson RJ, Carter R (1968) Vagotomy and pyloroplasty for perforated duodenal ulcer observations on 180 cases. Am J Surg 115: 173PubMedCrossRefGoogle Scholar
  14. 14.
    Jordan PH, Korompai FL (1976) Evolvement of a new treatment for perforated duodenal ulcer. Surg Gynecol Obstet 142: 391PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1980

Authors and Affiliations

  • V. I. Sreenivas
    • 1
    • 2
    • 3
  1. 1.The Hospital of Saint RaphaelNew HavenUSA
  2. 2.Department of SurgeryYale University School of MedicineNew HavenUSA
  3. 3.Yale New Haven HospitalNew HavenUSA

Personalised recommendations