Perforated peptic ulcer

Kjetil Søreide, Kenneth Thorsen, Ewen M. Harrison, Juliane Bingener, Morten H. Møller, Michael Ohene-Yeboah, Jon Arne Søreide

Research output: Contribution to journalReview article

76 Scopus citations

Abstract

Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are common causes, demographic differences in age, sex, perforation location, and underlying causes exist between countries, and mortality rates also vary. Clinical prediction rules are used, but accuracy varies with study population. Early surgery, either by laparoscopic or open repair, and proper sepsis management are essential for good outcome. Selected patients can be managed non-operatively or with novel endoscopic approaches, but validation of such methods in trials is needed. Quality of care, sepsis care bundles, and postoperative monitoring need further assessment. Adequate trials with low risk of bias are urgently needed to provide better evidence. We summarise the evidence for perforated peptic ulcer management and identify directions for future clinical research.

Original languageEnglish (US)
Pages (from-to)1288-1298
Number of pages11
JournalThe Lancet
Volume386
Issue number10000
DOIs
StatePublished - Sep 26 2015

ASJC Scopus subject areas

  • Medicine(all)

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    Søreide, K., Thorsen, K., Harrison, E. M., Bingener, J., Møller, M. H., Ohene-Yeboah, M., & Søreide, J. A. (2015). Perforated peptic ulcer. The Lancet, 386(10000), 1288-1298. https://doi.org/10.1016/S0140-6736(15)00276-7