Management of perforated of peptic ulcers in a secondary hospital of Burkina

Abstract

The aim of this study was to describe the treatment of perforative peptic ulcer and to evaluate the benefit of abdominal drainage. We conducted a cross-sectional study over 3 years. It included 129 patients operated for perforative peptic ulcer. Epidemiological, clinical, therapeutic and evolutionary features were evaluated. The average age of patients was 44 .8 years. We noted male patients (67.4 %). Sixteen patients (12.4 %) had an impaired general condition (stage 2 or more WHO classification). Hyperleukocytosis was noted in 49 cases (40 %) and anaemia in 60 cases (46.5 %). The average lime of surgical treatment was less than 24 hours in 46 patients (35.7 %).Treatment consisted in laparotomy, toilet of the peritoneal cavity and suture of the perforation. The closure of the abdominal cavity was performed with drainage in 84 cases (65.l %) and without drainage in 45 cases (34.9 %). The distributions of clinical, biological and evolutionary parameters were similar in the two groups, except for the leukocyte count. Parietal suppuration was noted in 16 cases (12.4 %). The average length of hospital stay was 6 days. Two patients (1.6 %) died. Peritonitis by perforation of gastric or duodenal peptic ulcers is responsible for significant morbidity in rural Burkina Faso. The benefit of abdominal drainage ÎJ1 terms of disease reduction is not evident.