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 journalLiterature reviewpeer-review

Abstract / Description of output

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
Pages (from-to)1288-98
Number of pages11
JournalThe Lancet
Volume386
Issue number10000
DOIs
Publication statusPublished - 26 Sept 2015

Keywords / Materials (for Non-textual outputs)

  • Humans
  • Peptic Ulcer Perforation
  • Postoperative Care
  • Prognosis

Fingerprint

Dive into the research topics of 'Perforated peptic ulcer'. Together they form a unique fingerprint.

Cite this