Perforated peptic ulcer in Khartoum state

Background: Although perforated peptic ulcer (PPU) is evaluated in different parts of the World, no study was held to evaluate the disease in Sudan. This study aimed to evaluate the incidence, clinical presentation, management and outcome of perforated peptic ulcer. Methods: Data from 58 consecutive patients with PPU was collected and analysed in the period between November 1999 and April 2002. Fifty-two (89.6%) were male patients and six (10.4%) females. Results: Twenty-five (43.1%) of the studied group were below 30 years of age, only 10(17.2%) were known cases of peptic ulcer disease. Twenty-two (40%) of perforations occurred during the month of Ramadan and most of the patients were fasting 20(34.4%). Forty-two (72.4%), of the total number of patients, presented during the winter season. Fiftythree (91.3%) were perforated duodenal ulcers and three (5.2%) were perforated gastric ulcers. Fifty-five (94.8%) had surgical treatment, 53(91.3%) patients had simple closure with omental patch. Postoperative complications occurred in 18 (31%) patients and there were seven (12%) deaths. The most significant factors for both morbidity and mortality were old age group, late presentation, concomitant medical illness, size of perforation more than two cm and shock on presentation. Conclusion: PUP predominantly occurred in young age group as compared to International data and most of the patients were not known to suffer from peptic ulcer disease. The incidence increased in winter season and during fasting