OPTIMIZATION OF THE TREATMENT AND DIAGNOSTIC ALGORITM FOR PERFORATED PYLORODUODENAL ULCERS.

Duodenal ulcer perforation is still a common complication of chronic peptic ulcer disease. Despite the wide spread use of anti‑secretory and H. pylori eradication therapy, the incidence of perforated duodenal ulcer (PDU) has changed little. Most of the literature pertaining to the situation in the developed world, showed that the disease is largely confined to the elderly patients taking ulcerogenic medications. The situation in the developed nations is summed up by Johnson: “The surgeon’s major role in the management of peptic ulcer disease will be the performance of life‑saving emergency operations in the elderly unfit patient.” In contrast to the developing world, the patients are younger and have a long life‑time of potentially useful activity ahead of them as anti‑secretory and anti‑H. pylori eradication drugs are been freely used, we had expected an improvement in this disease condition.