Abstract

To study the outcome and complications of surgery for duodenal perforation based on the: a) Duration of perforation. b) Patients presenting in a clinical state of shock. c) Clinical presentation. d) Radiological findings and management. Methods: This prospective study was conducted at the tertiary care center. The study will follow 50 duodenal perforation cases' clinical symptoms and prognosis. All tertiary care center patients who met the inclusion criteria were included in the data collection. Results: In this study, 76% of duodenal ulcer perforations were male and 34% were female, making the male: female ratio 3.16:1. 24% of patients presented after 24 hours and were from low-income families. Most patients were unskilled and semiskilled labourers with low socioeconomic situations. In the study, 76% of patients were smokers and alcoholics, which was the biggest risk factor for perforation, followed by 32% who had taken NSAIDs for various diseases. The diagnosis was based on air under the diaphragm in 94% of cases and absent in 6%. Paracentesis fluid was turbid and bile stained in 88% of patients and absent in 12%, aiding diagnose instances. 24% of patients were in shock at the casualty, and 41.7% died during treatment (12 shock cases, 5 died). Early patients with MPI <21 or between 21 and 29 without shock and no contraindications to anaesthesia can be treated with laparoscopic closure with less morbidity and mortality at a centre with modern anaesthetic equipment, a trained anaesthetist, and a surgeon skilled in laparoscopic techniques. Conclusion: Perforated peptic ulcer patients can tolerate perforation closure and long-term medical care. If the surgeon is well-trained, laparoscopic perforation closure is better than open surgery for early, non-shocked, healthy younger and middle-aged patients.

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