■胃十二指肠穿孔是一种常见的外科急症,在全球范围内仍然是巨大的健康负担,具有显著的发病率和死亡率。溃疡疾病仍然是胃十二指肠穿孔的最常见原因。诊断幽门螺杆菌的存在可以帮助从整个社区根除感染,从而减少胃十二指肠穿孔的机会。
■评估胃十二指肠穿孔患者的临床表现,并通过现有调查评估幽门螺杆菌感染的检测。
■对80例临床特征提示胃十二指肠穿孔并经临床证实的患者进行了一项描述性观察研究,2019-2020年期间在农村三级保健医院收治的放射学基础和手术结果。患者/派对的详细病史,临床检查,和血液/组织样本进行了调查。患者在研究所接受标准治疗方式的管理。收集数据,编译,并输入MSExcel并使用适当的软件进行分析。描述性分析以分类变量的比例形式进行,连续变量的平均值或中位数。
■胃十二指肠穿孔的病例更多发生在中晚期,主要影响已婚男性患者来自农村地区和非熟练工人。摄入辛辣食物的历史,长期饥饿,其中NSAID的使用史很常见.大多数患者过去有腹部疼痛史,提示有PUD和服用多种降酸剂的历史。他们中的大多数表现为上腹痛,呕吐,腹胀伴随腹膜炎的其他迹象。其中,肝暗淡和隔膜右穹顶下游离气体的消失也占很大比例。大多数病例在组织学上发现幽门螺杆菌阳性(85%),其次是快速尿素酶试验(RUT)(80%),血清IgG和IgA抗体的阳性率分别为72.5%和68.8%。与抗体检测试验相比,快速脲酶试验对幽门螺杆菌的诊断更为敏感和特异。
■发现早期发现幽门螺杆菌感染并在术后使用有效的抗幽门螺杆菌治疗是足够的。
UNASSIGNED: Gastro-duodenal perforation is a common surgical emergency that remains a formidable health burden worldwide with significant morbidity and mortality. Ulcer disease remains the most common cause of gastro-duodenal perforation. Diagnosing the presence of H. pylori can help eradicate the infection from the community at large and thereby reduce the chances of gastro-duodenal perforation.
UNASSIGNED: To assess the clinical presentation of gastro-duodenal perforation patients and to evaluate the detection of Helicobacter pylori infection by available investigations.
UNASSIGNED: A descriptive observational study was conducted among 80 patients presenting with clinical features suggestive of gastro-duodenal perforation and confirmed by clinical, radiological basis and operative findings admitted at a rural tertiary care hospital during 2019-2020. Detailed history was taken from the patient/party, clinically examined, and blood/tissue samples were investigated. The patients were managed with standard treatment modality in the studied institute. Data were collected, compiled, and entered MS Excel and analyzed using appropriate software. Descriptive analysis was done in the form of proportion for categorical variables, mean or median for continuous variables.
UNASSIGNED: Cases of gastro-duodenal perforations were more among middle to later age of life, mostly affecting married male patients hailed from rural area and unskilled workers. History of intake of spicy food, prolonged starvation, history of NSAID use were common among them. Majority of the patients had history of pain abdomen in the past suggesting of PUD and history of taking variety group of acid reducing agents. Most of them presented with epigastric pain, vomiting, abdominal distension along with other signs of peritonitis. Obliteration of liver dullness and free gas under right dome of diaphragm was also noted in large proportion among them. Majority of cases were found positive for H. pylori on Histology (85%), followed by rapid urease test (RUT) (80%) and a positivity of 72.5% and 68.8% on serum IgG and IgA antibody respectively. Rapid Urease Test was more sensitive as well as specific in diagnosing of H. pylori than antibody detection test.
UNASSIGNED: Early detection of H. pylori infection and treatment with potent anti H. pylori therapy postoperatively has been found to be adequate.