Initial Decisions for Peptic Ulcer Perforation

Abstract

Peptic ulcer perforation, despite anti-ulcer medication and Helicobacter pylori eradication, is still common in emergency surgery. Operative management includes primary repair, omental patch closure, vagotomy, and wedge resection. The choice of treatment should entail consideration of patient status, past medical history, chronic peptic ulcer history, and comorbidities. Giant peptic ulcer perforations are difficult or impossible to repair primarily. In such cases, there are various surgical options. Laparoscopic repair of peptic ulcer perforation is a safe procedure. However, there are several limitations, including the laparoscopic skill of the surgeon, and perforation size. In the high risk patient, non-surgical management such as percutaneous drainage under local anesthesia may be adapted with restrictions.

Keywords

• peptic ulcer
• perforation