Peptic Ulcer Perforation in Elderly: 10 years' Experience of a Single Institution

Abstract

Background: Peptic ulcer perforation (PUP) constitutes a unique situation characterized by severe pain, leading almost every patient with this complication to seek help in the hospital. However, clinical features of PUP in elderly patients are different from those of young or in adult patients; indeed, symptoms of PUP may be atypical in old age. Materials and methods: This was a retrospective study of patients who underwent emergency surgery for PUP between 2002 and 2012. The patients were divided into two age groups. Medical conditions of the patients that may have had an effect on the perforation, such as age, gender, concomitant disease, use of drugs, presence of Helicobacter pylori infection, characteristic of pain (vague abdominal pain or severe epigastric pain), smoking status, and duration symptoms at the time of admission, were evaluated. Results: A total of 261 patients were included in this retrospective study. Group I (n = 202) was composed of adults (age < 65 years), Group II (n = 59) was composed of geriatric patients (age >= 65 years). Male dominancy was observed in both groups. Primary closure of the perforation was the most common procedure performed. Hypertension (18.3 % and 52.5%, respectively), and diabetes mellitus (11.9% and 15.3%, respectively) were the most frequent comorbidities in both groups, whereas mortality and morbidity rates were higher in elderly group. Conclusions: PUP is a serious condition, particularly in geriatric age requiring emergency surgical management. Primary closure of the perforation was the most common procedure performed in our series. Copyright (C) 2013, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC.