Clinico-Pathological Pattern and Early Post-Operative Complications of Gastro-Duodenal Perforations at Mulago Hospital Kampala- A Prospective Cohort Study

M. Nansubuga; S. Kirunda; A. S. Wesonga; J. Yiga; P. Makobore; H. Wabinga; E. Elobu

M. Nansubuga
S. Kirunda
A. S. Wesonga
J. Yiga
P. Makobore
H. Wabinga
E. Elobu

Keywords: gastro-duodenal perforations, perforated peptic ulcer disease, gastric perforations

Abstract

Background: Gastro-Duodenal Perforations are one of the commonest causes of mortality and morbidity in conditions that require emergency surgery. The main objective of this study was to determine the clinico-pathological pattern and evaluate factors for early post- operative complications of Gastro-duodenal perforations in Mulago.

Methods: This was a prospective cohort study of patients with gastro-duodenal perforations managed by simple repair between September 2014 and April 2015 in Mulago was studied. Primary/ secondary outcomes were mortality and complications respectively. Data was managed using stata-12 and multivariate analysis using log-binomial regression model.

Results: A total of 65 patients were operated for Gastro-duodenal perforations in the study period. 86.2% were male (M: F 6.2:1). Median age was 35 years (range 16- 80 years). 93.9% had gastric perforations. Clinical diagnosis was predicted in 89.3%. H. pylori was present in 7.9%. Mortality was 18.5% and complications developed in 58.5%. Age above 35 and presence of co morbidity predicted mortality (CI 1.22- 21.12, p= 0.009) (CI 1.26- 8.82, p=
0.024) and early post-operative complications (CI 1.03- 2.44, p= 0.031) (CI 1.23- 2.44, p=
0.011) respectively.

Conclusion: Gastroduodenal perforations remain a common surgical emergency in Mulago hospital affecting mainly young men below 35 years. Majority are gastric perforations. Mortality and early post-operative complications are high, and increase with age and presence of co morbidity.

http://dx.doi.org/10.4314/ecajs.v21i2.1

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