Department of Surgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
J Pak Med Assoc. 2023 Jul;73(7):1506-1510. doi: 10.47391/JPMA.4768.
Duodenal ulcer perforation, a frequent surgical emergency, needs simple closure with indirect Graham's Omentopexy which is effective with excellent results in majority of cases despite patients' late presentation. The objective of the study was to determine the frequency of postoperative complications of perforated duodenal ulcer, conducted in the Surgery Department, Jinnah Postgraduate Medical Centre, Karachi, from March 20, 2018 to September 20, 2018. The study was a descriptive case series of 108 patients of both genders with perforated duodenal ulcer > 1 week old with ASA score I & II. Patients with trauma and comorbidities were excluded. The patients underwent laparotomy and peritoneal toilet, and after noting the site of perforation indirect Graham's Omentopexy was performed. Complications like duodenal fistula, peritonitis, and paralytic ileus, and patient's death within 10 days of surgery were noted. Age ranged from 18 to 50 years with mean age of 35.027±5.13 years, mean weight 71.120±12.77 kg, mean height 1.541 ±0.09 metres, mean BMI 29.975±4.99 kg/m2, and the mean duration of complaint was 4.194±1.30 weeks. Male predominance in 75 (69.4%) patients. Duodenal fistula was seen in 10 (9.3%) patients, peritonitis 12 (11.1%), paralytic ileus 14 (13%) and mortality was in 11 (10.2%) patients.
十二指肠溃疡穿孔是一种常见的外科急症,需要进行简单的缝合,并采用间接 Graham 网膜固定术。尽管患者就诊时间较晚,但该方法在大多数情况下都能有效,且效果良好。本研究旨在确定外科手术部在 2018 年 3 月 20 日至 9 月 20 日期间收治的穿孔性十二指肠溃疡患者术后并发症的发生率。这是一项描述性病例系列研究,共纳入 108 例年龄在 18-50 岁之间(平均年龄 35.027±5.13 岁)、性别不限、穿孔时间超过 1 周、ASA 评分 I 或 II 级的患者。排除创伤和合并症患者。所有患者均接受剖腹探查术和腹腔灌洗,并在确定穿孔部位后行间接 Graham 网膜固定术。记录十二指肠瘘、腹膜炎、麻痹性肠梗阻等并发症以及术后 10 天内的患者死亡情况。体重为 71.120±12.77kg,身高为 1.541±0.09m,BMI 为 29.975±4.99kg/m2,平均发病时间为 4.194±1.30 周。75 例(69.4%)患者为男性。10 例(9.3%)患者出现十二指肠瘘,12 例(11.1%)患者出现腹膜炎,14 例(13%)患者出现麻痹性肠梗阻,11 例(10.2%)患者死亡。