Background: The evolutionary profile of patients operated for
peptic ulcer perforation in Bujumbura. Perforated
peptic ulcer is a serious complication of peptic ulcer with potential risk of
grave complications. Aim: To study the early morbidity and mortality of
surgery for peptic ulcer perforation in Bujumbura City Hall hospitals: Kamenge
University Hospital Center (CHUK), Kamenge
Military Hospital (HMK) and Prince Louis Rwagasore Clinic (CPLR).Patients
and methods: This is a retrospective, descriptive and analytical study
carried out in the three hospitals of Bujumbura over a period of three years
from January 1, 2020 to December 31, 2022. It involved 57 cases (n = 57) of
peptic ulcer perforation. Results: The frequency of surgery for peptic
ulcer perforation was 2.7% with a mean age of 43.6 years +/-?15.3 years and a male predominance with a sex ratio of 3.7. Eight
percent of patients presented with shock, 24.5% were smokers, and 67.9% had
taken non steroidal anti-inflammatory drugs. The mean hospital stay was 15.2 days
with a standard deviation of 12.1. The morbidity rate was 30.2%, 32% were
classified in grade IIIb of the Clavien-Dindo Surgical Complications Scale.
There were 9 deaths (17%). Seven patients who underwent surgery and received
late consultations died.
References
[1]
Ongoïba, T. (2020) Perforation Peritonitis of Peptic Ulcer. Thesis in Medicine, University of Science, Technology and Technology of Bamako, Bamako. https://www.bibliosante.ml/handle/123456789/4206
[2]
Lau, J.Y., Sung, J., Hill, C., Henderson, C., Howden, C.W. and David, C.M. (2011) Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality. Digestion, 84, 102-113. https://pubmed.ncbi.nlm.nih.gov/21494041
[3]
Lawson-Ananissoh, L., Bouglouga, O., Bagny, A., Yakoubou, R., Kaaga, L. and Redah, D. (2015) Epidemiological Profile of Peptic Ulcers at the Lomé Campus Hospital and University Center (Togo). African Journal of Hepato-Gastroenterology, 3, 99-103. https://doi.org/10.1007/s12157-015-0597-5
[4]
Vignon, K.C., Mehinto, D.K., Vignon, K.R., Mbele, R., Natta, N. and Hounkpe, E. (2016) Peptic Ulcer Perforations at the National University Hospital Center (CNHU) in Cotonou (Benin). European Scientific Journal, 12, 117. https://doi.org/10.19044/esj.2016.V12n27p117
[5]
Ngo Nonga, B., MouafoTambo, F.F., Ngowe Ngowe, M., Takongmo, S. and Sossa, M.A. (2010) Etiologies of Acute Generalized Peritonitis at Yaoundé University Hospital. Revue Africaine de Chirurgie et Spécialités, 7, 30-32. https://doi.org/10.4314/racs.v4i7.66378
[6]
Mamoudou, C., Toumin, C., Aboubacar, D., et al. (2021) Peritonitis by Perforation of Peptic Ulcer in the Department of General Surgery of the Regional Hospital of Kankan (Guinea). SAS Journal of Surgery, 7, 726-729.
[7]
Chalya, P.L., Mabula, J.B., Koy, M., Mchembe, M.D., Jaka, H.M., Kabangila, R., et al. (2011) Clinical Profile and Outcome of Surgical Treatment of Perforated Peptic Ulcers in Northwestern Tanzania: A Tertiary Hospital Experience. World Journal of Emergency Surgery, 6, Article No. 31. https://pubmed.ncbi.nlm.nih.gov/21871104
[8]
Mbonicura, J.C., Baramburiye, C.P., Sibomana, T., Mugisha, J.P., Kazobavamwo, M., Harakandi, S., et al. (2021) Non-Traumatic Gastro-Intestinal Perforations in Bujumbura about 141 Cases. Thesis of Medicine, University of Burundi, Bujumbura.
[9]
Begovic, G. and Selmani, R. (2015) Etiological Factors in Urgent Gastroduodenal Ulcer. Prilozi, 36, 203-210. https://doi.org/10.1515/prilozi-2015-0068
[10]
Belhadj, H., Benelkhaiat, R. and Finech, B. (2011) Peritonitis by Ulcer Perforation: A Prospective Study over 1 Year. Thesis, Faculty of Medicine and Pharmacy-Marrakech, Marrakech.
[11]
Foppa, B., Muscari, F. and Duffas, J.P. (2005) Perforated Peptic Ulcer: Laparoscopic Treatment. Journal of Surgery, 142, 165-167. https://doi.org/10.1016/s0021-7697(05)80884-1
[12]
Ohene-Yeboah, M. and Togbe, B. (2006) Perforated Gastric and Duodenal Ulcers in an Urban African Population. West African Journal of Medicine, 25, 205-211. https://doi.org/10.4314/wajm.v25i3.28279
[13]
Ali, A.M., Mohamed, A.N., Mohamed, Y.G. and Keleşoğlu, S.İ. (2022) Clinical Presentation and Surgical Management of Perforated Peptic Ulcer in a Tertiary Hospital in Mogadishu, Somalia: A 5-Year Retrospective Study. World Journal of Emergency Surgery, 17, Article No. 23. https://wjes.biomedcentral.com/articles/10.1186/s13017-022-00428-w
[14]
Sacko, O., Diallo, S., Soumaré, L., Camara, M., Koumaré, S., Sissoko, M., Keita, S., Carol, Dakouo, D., Coulibaly, M., Traoré, M., Soumaré, G., Traoré, A.F., Dicko, H., Dianessi, Y., Traoré, B., Koita, A. and Zimogo, S. (2019) Perforations of Gastro-Duodenal Ulcers in the Surgery Department “A” at the University Hospital Point G Bamako. Surgical Science, 10, 265-270. https://doi.org/10.4236/ss.2019.108028
[15]
Siddeye, A. (2009) Peptic Ulcer’s Perforations. Thesis in Medicine, Point-G University Hospital, Bamako.
[16]
Issouf, C. (2004) Peptic Ulcer Perforations at the Gabriel Touré Hospital. Thesis in Medicine, Gabriel Touré University, Bamako.
[17]
Coulibaly, M.M. (2017) Peritonitis by Gastroduodenal Perforation in the General Surgery Department of Sikasso Hospital; USTTB.
[18]
Cougard, P, Barrat, C, Gayral, F, Cadiѐre, G. B., Meyer, C., Fagniez, L., et al. (2000) Laparoscopic Treatment of Perforated Duodenal Ulcer. Results of a Multicenter Retrospective Study. Annals of Surgery, 125, 726-731. https://doi.org/10.1016/s0003-3944(00)00267-4
[19]
Montalvo-Javé, E.E., Corres-Sillas, O. and Athié-Gutiérrez, C. (2011) Factors Associated with Postoperative Complications and Mortality in Perforated Peptic Ulcer. Cirugia y Cirujanos, 79, 141-148. https://pubmed.ncbi.nlm.nih.gov/21631975
[20]
Kim, J.M., Jeong, S.H., Lee, Y.J., Park, S.T., Choi, S.K., Hong, S.C., et al. (2012) Analysis of Risk Factors for Postoperative Morbidity in Perforated Peptic Ulcer. Journal of Gastric Cancer, 12, 26-35. https://pubmed.ncbi.nlm.nih.gov/22500261
[21]
Sivaram, P. and Sreekumar, A. (2018) Preoperative Factors Influencing Mortality and Morbidity in Peptic Ulcer Perforation. European Journal of Trauma and Emergency Surgery, 44, 251-257. https://pubmed.ncbi.nlm.nih.gov/28258286
[22]
Zittel, T.T., Jehle, E.C. and Becker, H. (2000) Surgical Management of Peptic Ulcer Disease Today—Indication, Technique and Outcome. Langenbeck’s Archives of Surgery, 385, 84-96. https://pubmed.ncbi.nlm.nih.gov/10796046
[23]
Wacha, H., Linder, M.M., Feldmann, U., Wesh, G., Steinfensand, R.A. and Gundlach, E. (1987) The Mannheim Peritonitis Index. An Instrument for the Intraoperative Prognosis of Peritonitis. Chirurgie, 58, 84-92. https://pubmed.ncbi.nlm.nih.gov/3568820
[24]
Bupicha, J.A., Gebresellassie, H.W. and Alemayehu, A. (2020) Pattern and Outcome of Perforated Peptic Ulcer Disease Patient in Four Teaching Hospitals in Addis Ababa, Ethiopia: A Prospective Cohort Multicenter Study. BMC Surgery, 20, Article No. 135.
[25]
Bas, G., Eryilmaz, R., Okan, I. and Sahin, M. (2008) Risk Factors of Morbidity and Mortality in Patients with Perforated Peptic Ulcer. Acta Chirurgica Belgica, 108, 424-427. https://doi.org/10.1080/00015458.2008.11680254
[26]
Taş, L., Ulger, B.V., Őnder, A., Kapan, M. and Bodzag, Z. (2015) Risk Factors Influencing Morbidity and Mortality in Perforated Peptic Ulcer Disease. Turkish Journal of Surgery/Ulusal Cerrahi Dergisi, 31, 20-25.
[27]
Noguiera, C., Silva, A.S., Santos, J.N., Silva, A.G., Ferreira, J., Matos, E., et al. (2003) Perforated Peptic Ulcer: Main Factors of Morbidity and Mortality. World Journal of Surgery, 27, 782-787. https://pubmed.ncbi.nlm.nih.gov/14509505
[28]
Moller, M.H., Adamsen, S., Thomsen, R.W. and Moller, A.M. (2011) Multicentre Trial of a Perioperative Protocol to Reduce Mortality in Patients with Peptic Ulcer Perforation. British Journal of Surgery, 98, 802-810. https://pubmed.ncbi.nlm.nih.gov/21442610