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Nonoperative Treatment of Perforated Duodenal Ulcer
Thomas V. Berne, MD;
Arthur J. Donovan, MD
Arch Surg. 1989;124(7):830-832.
Abstract
• This report concerns 35 adult patients in whom perforation of a duodenal or prepyloric ulcer was treated nonoperatively between July 1979 and April 1988 at the Los Angeles County–University of Southern California Medical Center, Los Angeles. Each patient had pneumoperitoneum with clinical evidence of peritonitis, and a gastroduodenogram documented a sealed perforation. The ulcer was believed to be acute in 27 patients and chronic in 8. These 35 cases represent 12% of 294 cases of duodenal and prepyloric peptic ulcers with perforation treated during the same period. An intra-abdominal abscess developed in 1 of the 35 patients. Reperforation did not occur. The mortality rate for the 259 cases treated operatively during this period was 6.2%; the mortality rate of the 35 cases treated nonoperatively was 3%. Duodenal ulcer can be safely treated nonoperatively when a gastroduodenogram documents self-sealing.
(Arch Surg. 1989;124:830-832)
Author Affiliations
From the Department of Surgery, University of Southern California School of Medicine, and the Los Angeles County–University of Southern California Medical Center, Los Angeles.
Footnotes
Accepted for publication February 28, 1989.
Read before the 96th Annual Meeting of the Western Surgical Association, San Diego, Calif, November 16, 1988.
Reprint requests to Department of Surgery, Los Angeles County–USC Medical Center, 1200 N State St, Los Angeles, CA 90033 (Dr Berne).
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