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TITLE:

NON-SURGICAL TREATMENT OF PERFORATED PEPTIC ULCER: AN ALTERNATIVE DEFINITIVE TREATMENT

AUTHORS:

Dr Umer Anwar, Dr Tashfeen Farooq, Dr Muhammad Hasnain

ABSTRACT:

Introduction: Peptic perforation is a common surgical case that occurs as an acute abdomen. Fortunately, perforation, which is potentially the most serious complication for a patient with an ulcer, is rare. It probably does not affect more than 2% of patients with peptic ulcer disease. Therapy options accepted in perforated peptic ulcer are simple closure or immediate action. Conservative / non-surgical treatment originally recommended by Wangensteen was proposed as the preferred treatment for peptic ulcer pierced by Taylor in 1956. Material and method: This study is a retrospective prospective study conducted with the diagnosis and determination of dry peptic perforation and review of patient records. In the prospective study 25 patients the study groups who presented as peptic perforation to be sealed and/ or hemodynamically stable patients with peptic perforation and/or with other serious illness when the risk of surgery is prohibitive. Place and Duration: In the Surgical Unit I and Medical Unit II of Benazir Bhutto Hospital, Rawalpindi for one year duration from February 2018 to February 2019. Objectives and tasks: Achieving efficacy and safety of conservative / non-surgical treatment of perforated peptic ulcer, as well as observing complications leading to morbidity and mortality. It was also aimed at achieving and assessing the criteria used in the conservative treatment of peptic perforation. Results: In 75 cases, non-surgical treatment was preferred. 60% (80%) of the total was cured by non-surgical treatment. Six patients (8%) underwent surgical intervention and were considered to be unsuccessful in conservative treatment, 4 patients (5.33%) experienced complications and the mortality rate was 9.33%. Key words: Peptic perforation, dry perforation, non-surgical treatment.

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