FREQUENCY OF HELICOBACTER PYLORI IN PATIENTS PRESENTED WITH PERFORATED PEPTIC ULCER

Abstract

Objective: To study the frequency of H-pylori infection in patients with perforated peptic ulcer disease (Duodenal and Gastric).
Material and Methods: During the study period a total of 85 patients were admitted with acute perforated peptic ulcer to surgical "C" unit Lady Reading Hospital, Peshawar from June 2004 to December 2005. They were operated and post operatively blood sample was taken for identification of antibodies against H-pylori by ELISA method. All patients irrespective of gender and age who were operated for perforated peptic ulcer were included in the study. Patient who gave history of intake of H2 receptor antagonist and Proton Pump Inhibitors up to six weeks prior to their presentation were excluded.
Results: Out of 85 patients studied and analyzed for antibodies against H-pylori, 77 (90.59%) were male and 8 (9.41%) were female. Age ranged from 30-75 years. ELISA showed that 56.46 % (n=48) were positive while 43.54 % (n=37) were negative for antibodies against H-pylori. 87% (n=54) patients gave history of chronic dyspepsia. 47 of these were positive for H-pylori. All patients were treated with eradication therapy which consisted of clarithromycin, metronidazole and omeprazole. Six weeks after initial surgery blood samples were analysed for H-Pylori and were found to be negative.
Conclusion: Patients who present with perforated peptic ulcer and gave history of chronic dyspepsia should be given eradication therapy post-operatively in order to reduce the incidence of recurrence.