แผลทะลุของกระเพาะอาหาร ในโรงพยาบาลนครปฐม

บทคัดย่อ

Perforated peptic ulcer is a common surgical emergency in which accurate diagnosis and timely surgical treatment are necessary. This study is a retrospective review of 149 patients with perforated peptic ulcer in Nakhonpathom hospital from 2005 - 2009. The purpose of the study is to evaluate the physicians’ treatment and decision making process of this condition. The study found the most frequent treatment was simple suture with omentum graft. The most common site of pathology was prepyloric (72.48%). Most patients (90.6%) improved. However mortality rate was 9.4%. Septicemic shock is the most common cause of death. In order to improve treatment outcome, it is necessary to initiate diagnostic process as soon as possible, to optimize preoperative preparation and propose to use Boey scoring system to predict the rate of complication or death, and to consider the most appropriate surgical approach for each patient.