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Factors Affecting Morbidity and Mortality Rates in the Management of Perforated Duodenal Ulcer
العوامل المؤثرة على معدل الاصابات والوفيات في علاج قرحة الاثنى عشري المنفجرة

Authors: Ahmed Abd Al-Raheem AL-Zubaydi احمد عبد الرحيم الزبيدي --- Nada M. Jawad ندى محمد جواد كاظم
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 1 Pages: 69-74
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract: Objectives: To assess the surgical management of perforated duodenal ulcer with regards to certain factors and determined the association of these factors with morbidity, mortality& complication. Patients & Methods: A total number of 60 patients with duodenal perforations were included in this cross-sectional study. They were treated in Baghdad and Tikrit Teaching Hospitals during the period from July 2001 to Dec. 2002. Results: The patients with perforated DU were 55 males 91.7% & five females 8.3% with age ranging from 18-65 years and the mean age was 35 years. Only three died so the case fatality rate was 5%, complications developed in 14(23.3%) patients. Some factors play a role such as age, duration between perforation and treatment, Extent of peritonitis, shock, type of surgery, concurrent medical diseases and, history of DU.Conclusion: We can conclude that elderly shocked patients who presented late and gave at least one concomitant medical disease have significantly higher morbidity, mortality. Key words: Morbidity, Mortality, Perforated Duodenal Ulcer.

الملخص:التعرف على نوعية العملية الجرحية لمعالجة قرحة الاثنى عشري المنفجرة ومعرفة العوامل المؤثرةالتصميم: دراسة مقطعيةالمكان: مستشفى بغداد ومستشفى الكندي التعليمي الطريقة: جمعت المعلومات للمرضى المراجعين(60 مريض) وتم استجواب المرضى عن بعض العوامل المؤثرة ( العمر,تاريخ الاصابة بالقرحة, الصدمة, مدة انفجار القرحة,شدة ومدى التهاب غشاء البريتون, وجود الامراض الباطنية المرافقة ونوع العملية الجراحية التي اجريت)الدراسة بدات من تموز 1998 الى كانون الاول1999 جمعت المعلومات وتم تحليلها باستخدام التكرارات والنسبة المئوية ومربع كاي. النتائج:- كان عدد المرضى60(55 ذكور, 5 اناث) والاعمار بين(18-65 سنة) وعدد الوفيات ثلاثة(5%) والمضاعفات التي ظهرت لدى 14 مريض (23.3%) ودرست كافة العوامل المؤثرة وكان عامل العمر لا توجد علاقة احصائية معنوية بينما في حالة الفترة بين المعالجة وفترة حدوث انفجار القرحة ومدى انتشار التهاب البريتون ومرافقة امراض باطنية اخرى كانت هناك علاقة احصائية معنوية بينما لا توجد هذه العلاقة في حالة الصدمة وتاريخ سابق للقرحة ونوعية العملية الجراحية الاستنتاج:- ان المتقدمين بالعمر ولديهم صدمة قبل مراجعة المستشفى وتاخر حضورهم ولديهم احد الامراض الباطنية المرافقة للمريض كانت هناك علاقة كبيرة في حالة الاصابة والوفيات والمضاعفات.


Article
The Effect of Ramadan Fasting on Duedenal Ulcer Perforation

Authors: Wissam Jaffar Altaee --- Safa M. Mahdi Alobaidi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 381-387
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Fasting during the month of Ramadan is one of the five holy pillars in the Islamic faith and is an important annual ritual practiced by all Muslims. This involves fasting from dawn to dusk, followed by a break of fast at designated times. The length of fasting varies from ten to 19 hours, depending on the season in which the fasting month of Ramadan falls and the geographical locations.OBJECTIVE:1st to evaluate the relation between Ramadan fasting & duodenal ulcer perforations & 2nd to asses the risk factors of this complications .PATIENTS & METHODS :This is a prospective study in Baghdad Teaching Hospital – Medical City . Data from 231 consecutive patients with perforated duodenal ulcer from the period of October 2007 to December 2010 were collected & analyzed & all the patients were managed surgically after resuscitation in emergency unit .RESULTS :(96/231, 41.6%) of patients with perforated duodenal ulcer during Ramadan vs. (135/231, 58.4%) during the rest of the years . (96/490, 19.5%) of patients with perforated duodenal ulcer from the total number of all patients with acute abdomeninal surgeries during Ramadan. 43 % of patients smoking & 47 % of patients had a previous history of acid peptic disease in Ramadan. 54 % of patients were in between (20 to 40) years age group and the male to female ratio was 6 :1 . 15% patients of perforated duodenal ulcer had history of regular use of non steroidal anti inflammatory drugs.. Erect chest x-ray demonstrated gas under the diaphragm in 86% . Only 2 patients had a previous surgery of duodenal ulcer perforation .CONCLUSION:This study suggests that the incidence of duodenal ulcer perforation is relatively high in Ramadan among the people, who are fasting & have predisposing factors ( smoking , history of acid peptic disease , non steroidal anti-inflammatory drugs ) and need special precaution during this month


Article
Risk Factors for Acute Perforated Duodenal Ulcers in Erbil Governorate-Kurdistan, Iraq
عوامل الخطر لقرحة الاثني عشر الحادة في محافظة أربيل - كوردستان، العراق

Authors: Sherwan Ahmed Garota --- Abdulqadir Maghded Zangana
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2009 Volume: 13 Issue: 1 Pages: 1-5
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: Acute perforations of duodenal ulcers continue as one of the real emergencies of surgery which require immediate attention and prompt operation. The aim of this study was to evaluate the probable risk factors for perforation of duodenal ulcer, highlighting any prevalent one in the occurrence of perforation in Erbil governorate. Design: Retrospective study. The cases were selected on the basis of structured protocol. Setting: The study was performed on 124 patients with perforated duodenal ulcer attending the emergency departments of the three major hospitals in Erbil city (Erbil emergency hospital, Hawler teaching hospital and Hawler private hospital) Erbil governorate located in Iraqi Kurdistan over a period of 4 years.Methods: The study was performed on 124 patients with perforated duodenal ulcer over a four year period (Jun. 2000- Jun. 2004). A number of probable risk factors for perforation of the duodenal ulcer were studied. Asymptomatic patients who perforated were studied as a separate group.Results: one hundred twenty four patients with duodenal ulcer perforation were studied, 111 male and 13 female (male to female ratio 8.5:1) about 60% of patients were within their 4th and 5th decade of age. Patients residing in the rural areas had a lower incidence of perforation (39%) than that living in the urban areas (61%). seventy four patients (59.6%) were asymptomatic before they developed the perforation. Sixty six patients (53.2% of the total number) developed the perforation during Ramadan fasting months (four out of the total 48 months), sixty five percent of the cases were smokers. Stress and smoking played a significant rule in the occurrence of perforation in 83% of cases.Conclusions: Stress, smoking and fasting played a major rule as a risk factor in the occurrence of duodenal ulcer perforation. A high incidence of perforation occurs during the months of Ramadan fasting, especially those without or on irregular treatment. The incidence of asymptomatic patients who were fasting and under stress, who then perforated was high.


Article
Risk factors for perforated duodenal ulcer in sulaemania city
عوامل خطر الإصابة بقرحة الاثني عشر المثقبة في مدينة السليمانية

Authors: Muhammed Abulrahman Mahmood --- Zanko Sherko Fathalah --- Taher Abdullah Hawrame
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2010 Volume: 14 Issue: 3 Pages: 61-66
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and Objective: This prospective study was to evaluate the probable risk factors for perforation of duodenal ulcer, highlighting any prevalent one in the occurrence of perforation in Sulaemania city. The study was designed to be performed on patients with perforated duodenal ulcer attending the emergency department in Sulaemania teaching hospital over the period of this study.Method: This study was conducted between 1st of March 2009 till the 1st of October 2009 involving 50 patients with perforated duodenal ulcer attended the emergency department in Sulaemania teaching hospital. A number of probable risk factors for the patients were studied.Results: Out of 50 patients, 41(82%) were males, 9(18%) were females and the male to female ratio was (4.5:1), about 32% of the patients were more than 60 years old. Patients described themselves as having a nervous personality were 31(62%) and the number of patients lived in city center were 28(56%). Smoker patients were 36(72%) and 33 patients (66%) had a history of NSAIDs ingestion.Conclusion: Smoking, NSAIDs ingestion, sex, age and stress played a major role as risk factors in the occurrence in duodenal ulcer perforation. There is a seasonal variation in incidence of perforation including high incidence during spring and autumn.

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