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1. Clinical Study on Patients with Duodenal Perforation Bhagwan Raghunath Korde, Kapildev Ganeshrao Patil
Background: Due to patient delays, surgical delays, and a shortage of antibiotics, perforated duodenal ulcers, the most serious consequence, used to have a high death rate. According to several writers, during the previous three decades, there has been a decrease in the incidence of peptic ulcer illness and perforation. The treatment of peptic ulcer disease has changed, and surgery has become less necessary as a result of advancements in the use of a variety of medications in medical therapy. Males are more likely to experience perforation in their third and fourth decades, and the epidemiological pattern varies globally. The incidence in Western nations is somewhat dropping. Throughout this time, there has been an increase in the age of ulcer perforation patients, with younger patients experiencing a decline in incidence and older patients experiencing an increase in incidence. While the rates of stomach ulcer perforation seem to have remained rather consistent, the majority of this temporal variance may be related to shifting rates of duodenal ulcers in men. Aim: The aim of the study was to review and study the factors influencing, the outcome of the duodenal perforations. Material and Method: The Department of Surgery carried out this cross-sectional investigation. The admitting surgeon made the diagnosis of duodenal ulcer perforation based on clinical characteristics, which was supported by radiographic data and limited during the procedure. Surgery was classified as urgent if it was performed within four hours of admission, same day (4–24 hours), or later in the same admission. Fifty cases of duodenal ulcer perforation that were admitted to the Department of Surgery are included in this study. The location and type of operation carried out were included in the operational information. The information will be placed into a proforma together with the patient’s course of hospitalization, therapeutic interventions, and demographic information. Results: Fifty patients in total were examined. With a mean age of 45.68 years, the age ranged from 20 to 50 years. The age range between 41 and 50 years old had the highest prevalence among 50 patients, followed by 21 to 29 years old. There are 46 (92%) men and 5 (8%) women in the current study, with a majority of men. The majority of patients are admitted in less than a day; pre-pyloric ulcers typically manifest in this manner. Two cases of ileal perforations were multiple, whereas duodenal ulcer perforations were single. Smoking is the primary risk factor for ulcer complications brought on by ARDS in 12% of patients (6 patients). Of these patients, 30% experienced wound issues, 2% died (1 patient), and 44% (22 patients) had no complications at all. Conclusion: Acute abdominal emergencies involving perforations of the duodenum are among the most frequent. Early hospital admission, early diagnosis, timely surgical treatment, and the use of suitable and sufficient antibiotics have all contributed to a decrease in the mortality rate from perforated duodenal ulcers. Patients with duodenal perforation may experience lower morbidity and mortality rates if they smoke, drink alcohol, and change their lifestyle. Acute abdominal emergencies involving perforations of the duodenum are among the most frequent. Peptic ulcer perforation is among the most frequent reasons that need for an urgent laparotomy. Men are more likely to be impacted, with a peak occurrence in their 30s. Pylorus and the duodenum are the most often perforated organs.