Abstract
Because no large series of perforated peptic ulcers has been reported from Canada, 402 cases from the Ottawa Civic Hospital were reviewed to study this dramatic disorder.
The incidence was 15 per 100,000 population annually, or one in every 1000 hospital admissions.
The incidence in females and the elderly in this series was higher than reported elsewhere. The risk of perforation increased with age, being greatest after 55; this was not due to an excess of chronic ulcers in older patients, indicating that ageing is an etiological factor.
As the mortality of perforated peptic ulcer—20%—had remained unchanged over the years, fatal cases were studied to see if changes should be made in the management of this condition. The mortality for patients undergoing operation was 7.5%. Patients treated conservatively because their general condition was poor, died. Fifteen patients, in whom an incorrect diagnosis was made, died. More aggressive therapy and greater efforts at diagnosis might have saved some of these patients.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- 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]
- 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]
- KAO T. C., HSU S. C., HHSIEH C. S. PRIMARY GASTRECTOMY FOR PERFORATED PEPTIC ULCER, WITH FOLLOW-UP STUDIES. Surgery. 1964 Sep;56:487–496. [PubMed] [Google Scholar]
- KRIPPAEHNE W. W., FLETCHER W. S., DUNPHY J. E. ACUTE PERFORATION OF DUODENAL AND GASTRIC ULCER. FACTORS INFLUENCING MORTALITY. Arch Surg. 1964 May;88:874–882. doi: 10.1001/archsurg.1964.01310230150028. [DOI] [PubMed] [Google Scholar]
- 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]
- MacKay C. Perforated peptic ulcer in the West of Scotland: a survey of 5,343 cases during 1954--63. Br Med J. 1966 Mar 19;1(5489):701–705. doi: 10.1136/bmj.1.5489.701. [DOI] [PMC free article] [PubMed] [Google Scholar]