A Five-Year Review Of Perforated Peptic Ulcer Disease in a Tertiary Hospital in Lafia, North-Central Nigeria

Abstract Background: Perforated peptic ulcer disease is a life-threatening surgical emergency associated with high morbidity and mortality in the absence of prompt surgical intervention. Objective: To determine the pattern of presentation and outcome of management of perforated peptic ulcer disease patients in a tertiary hospital in Lafia, North- central Nigeria. Methodology: A structured questionnaire was used to extract clinico-epidemiological and outcome data of perforated peptic ulcer disease patients operated over a 5-year period. Chi- square test was used to analyze categorical variables while Mann- Whitney test was used for continuous variable analysis. Statistical significance was inferred at P-value of < 0.05. Results: We documented 74 patients, 69 (93.2%) males. The mean age was 38 ±12.8years and majority of the patients were farmers (43.2%). Chronic non-steroidal anti-inflammatory drug use was the most common risk factor documented. Sixty-six (89.1%) patients presented after 24 hours of onset of symptoms. A total of 57(77%) patients had gastric perforations. The most common complication was surgical site infection among 29(39.2%) patients, followed by multiple organ failure, 9 (12.2%) and repair leak, 5(6.8 %). Mortality rate was 23% and was found to be more common among those patients who presented late and those with multiple organ failure. Mortality was significantly associated with age greater than 60 years (p=0.004), primary level of education (p=0.019) and post-operative complications (p=0.001). Conclusion: Perforated peptic ulcer accounts for high morbidity and mortality in our study and mainly affected the youths. Chronic non-steroidal anti-inflammatory drug use was the dominant risk factor. Old age, primary level of education, late presentation and post-operative complications were found to increase mortality.