European Journal of Molecular & Clinical Medicine

Abstract

Immediate treatment of perforated ulcer has been established procedure for some time now. It can be stated that immediate definitive surgery like truncal vagotomy with drainage procedure or proximal gastric vagotomy (PGV) after simple closure with or without an omental patch, for a perforated peptic ulcer offers the prospects of a permanent cure with a mortality and morbidity comparable to that of patients with elective surgery, also chances of complication like the biliary leak after simple closure of perforation is much less than after definitive surgery for perforated duodenal ulcer. Out of 50 cases admitted, all 50 cases were subjected to emergency laparotomy. At laparotomy, site of perforation, size of perforation and amount of peritoneal contamination were determined. Following definitive procedure i.e., closure of perforation with posterior G.J. or with bilateral truncal vagotomy and simple closure of perforation with or without omental patch were done. Simple closure of perforation with omental plug (Graham's patch) was procedure of choice and was done in 39 cases (78%). Definitive surgery (bilateral truncal vagotomy with posterior gastric-jejunostomy) was done in 11cases (22%) definitive surgery was done in those patients, who had perforation for less than 24 hrs. were hemodynamically stable and who had previous history of peptic ulcer disease and were treated for PUD (Patient having Chronic Ulcer) similar seasonal variation of perforation.