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. 1971 Aug 7;105(3):263-269, 282.

Treatment and Mortality of Perforated Peptic Ulcer: A Survey of 852 Cases

MM Cohen
PMCID: PMC1931129  PMID: 5563345

Abstract

All proved cases of perforated peptic ulcer occurring in the Greater Vancouver area during the decade 1959-1968 have been studied. The incidence of perforation was approximately 10 per 100,000 population. The mean age was 55 years and the peak age incidence was in the fifth decade. The site of perforation was pyloroduodenal in 88% of cases and simple closure was the treatment employed in 81%. The overall mortality rate was 18.3% and one-third of these fatalities were due to misdiagnosis. The operative mortality rate was 9%.

The overall mortality rate was significantly greater among women and the elderly, in gastric perforations, and in perforations occurring between 11 p.m. and 8 a.m.

A close correlation was found between operative mortality rate and the time interval between perforation and operation. This elapsed time was found to be significantly greater among women and the elderly, in gastric perforations and in perforations occurring during the night.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AMERSON J. R. Acute gastroduodenal perforations; a study of three hundred and eighty-one patients. Am Surg. 1957 Aug;23(8):735–746. [PubMed] [Google Scholar]
  2. ANTILA L. E. PERFORATED PEPTIC ULCER WITH GENERALISED PERITONITIS. EARLY AND LATE PROGNOSIS IN 413 CASES. Acta Chir Scand. 1964 Oct;128:406–413. [PubMed] [Google Scholar]
  3. Burdette W. J., Rasmussen B. Perforated peptic ulcer. Surgery. 1968 Apr;63(4):576–585. [PubMed] [Google Scholar]
  4. Cassell P. Perforated duodenal ulcer in Reading from 1950 to 1959. Gut. 1969 Jun;10(6):454–459. doi: 10.1136/gut.10.6.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cohen M. M. Perforated peptic ulcer in the Vancouver area: a survey of 852 cases. Can Med Assoc J. 1971 Feb 6;104(3):201–205. [PMC free article] [PubMed] [Google Scholar]
  6. Devitt J. E., Taylor G. A. Perforated peptic ulcer. Can Med Assoc J. 1967 Mar 4;96(9):519–523. [PMC free article] [PubMed] [Google Scholar]
  7. Hinshaw D. B., Pierandozzi J. S., Thompson R. J., Jr, Carter R. Vagotomy and pylorplasty forperforated duodenal ulcer. Observations on 180 cases. Am J Surg. 1968 Feb;115(2):173–176. doi: 10.1016/0002-9610(68)90025-1. [DOI] [PubMed] [Google Scholar]
  8. JAMIESON R. A. Acute perforated peptic ulcer; frequency and incidence in the West of Scotland. Br Med J. 1955 Jul 23;2(4933):222–227. doi: 10.1136/bmj.2.4933.222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. LAZARUS S. PERFORATED PEPTIC ULCER IN ISRAEL. Gut. 1964 Dec;5:590–596. doi: 10.1136/gut.5.6.590. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. MAGLADRY G. W., Jr, HERROD C. E., MATHEWSON C., Jr Perforations of gastroduodenal ulcers; analysis of two hundred two cases. AMA Arch Surg. 1953 Jun;66(6):810–817. doi: 10.1001/archsurg.1953.01260030830012. [DOI] [PubMed] [Google Scholar]
  11. MacKay C. Deaths from perforated peptic ulcer. A survey of 633 cases in the west of Scotland. Scand J Gastroenterol. 1966;1(4):299–305. [PubMed] [Google Scholar]
  12. Machayya M. G. Emergency vagotomy and pyloroplasty for perforated duodenal ulcer: study of 73 cases. Br Med J. 1968 Oct 19;4(5624):155–156. doi: 10.1136/bmj.4.5624.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Maynard A. D., Froix C. J., Oropeza G. Gastroduodenal perforation. Arch Surg. 1968 Jul;97(1):96–104. doi: 10.1001/archsurg.1968.01340010126014. [DOI] [PubMed] [Google Scholar]
  14. NORBERG P. B. Results of the surgical treatment of perforated peptic ulcer: a clinical and roentgenological study. Acta Chir Scand Suppl. 1959;Suppl 249:1–128. [PubMed] [Google Scholar]
  15. Neilson J. Perforated peptic ulcer in South West Scotland. J R Coll Surg Edinb. 1968 Jan;13(1):40–45. [PubMed] [Google Scholar]
  16. O'DONOGHUE J. B., JACOBS M. B., O'DONOGHUE J. B., Jr Acute perforation of gastric and duodenal ulcers; a report of 600 cases. Rev Gastroenterol. 1951 Feb;18(2):113–127. [PubMed] [Google Scholar]
  17. PULVERTAFT C. N. Peptic ulcer in twon and country. Br J Prev Soc Med. 1959 Jul;13:131–138. doi: 10.1136/jech.13.3.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Reimers J. Perforating gastric and duodenal ulcers. Primary resection versus suture: an analysis of two 15-year series. Acta Chir Scand. 1967;133(5):381–391. [PubMed] [Google Scholar]
  19. SCHMITZ E. J., HARKINS H. N., OLSON H. H., MOORE H. G., Jr, MERENDINO K. A. Perforated peptic ulcer; a study of 136 cases in a county hospital. Ann Surg. 1953 Nov;138(5):689–697. doi: 10.1097/00000658-195311000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. SHEDD C. G., SCHWARTZ I. Acute perforated peptic ulcer. Rev Gastroenterol. 1950 Jul;17(7):568–576. [PubMed] [Google Scholar]
  21. Sanders R. Incidence of perforated duodenal and gastric ulcer in Oxford. Gut. 1967 Feb;8(1):58–63. doi: 10.1136/gut.8.1.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Singh B. N., Taylor B. B. Perforated peptic ulcer in Auckland and Glasgow. Aust N Z J Surg. 1967 Nov;37(2):193–196. doi: 10.1111/j.1445-2197.1967.tb04011.x. [DOI] [PubMed] [Google Scholar]
  23. TAYLOR H. Guest lecture: the nonsurgical treatment of perforated peptic ulcer. Gastroenterology. 1957 Sep;33(3):353–368. [PubMed] [Google Scholar]

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