Clinical presentation and outcome of perforated peptic ulcer patients at Dr. Soetomo Hospital Surabaya, Indonesia

Abstract

Background: Perforated peptic ulcer often occurs in peptic ulcer disease. Identifying the clinical presentation before any operation is important to predict mortality and decision-making about management perforated peptic ulcers. Until to date, there is no report data of perforated peptic ulcer characteristics at Dr Soetomo Hospital Surabaya. Methods: This is a non-experimental study with descriptive retrospective design. Data were collected retrospectively from medical records all consecutive patients with diagnosis of perforated peptic ulcer at Dr. Soetomo Hospital 2020 - 2022. Results: For three years, 97 patients were treated with perforated peptic ulcers with a high mortality of 48.5%. Patients were 67% male and 33% female with an average age of 61.4 ± 12.1 years old. There are two options for source control management: external drainage in patients with a Boey score of 3 with a mortality rate of 78.9% and definitive laparotomy repair perforation with a mortality rate of 28.8%. Patients with hemodynamic instability and sepsis have a high mortality rate. The most comorbid patients with perforated peptic ulcer are peripheral vascular disease, endocrine disorders,and lung disease. Conclusion: Patients with perforated peptic ulcers at Dr. Soetomo Hospital have a high mortality rate. Treatment can be in the form of definitive surgery and external drainage. However, external drainage has a high mortality rate.