Perforated duodenal and gastric ulcers in the Nigerian Savannah.

In the developing world, "pyloric stenosis" has been reported as the most frequent complication of peptic ulcer, hemorrhage and perforation being uncommon. However, in Zaria, situated in the Savannah zone of Nigeria, 74 (24%) of the 302 patients operated upon for duodenal ulcer and 29 (58%) of the 50 operated upon for gastric ulcer between 1971 and 1983 presented with perforations. In the combined group, the frequency of perforations increased from 16% in 1971-74 to 31% in 1975-78 and 45% in 1979-83. At the same time the total number of operations for duodenal ulcer has decreased. This may represent a distinctive feature of the savannah with reference to the geographical aspects of peptic ulcer surgery.