FREQUENCY OF DUODENAL ULCER PERFORATION WITH RADIOLOGICAL EVIDENCE OF PNEUMOPERITONEUM

Abstract

Objectives: To determine the frequency of duodenal ulcer perforation with radiological evidence of gas under the diaphragm on X-ray chest.
Study design: Descriptive
Place and Duration of study: Department of Surgery Combined Military Hospital (CMH) and Military Hospital (MH), Rawalpindi, from Nov, 2005 to May 2006.
Patients and Methods: Patients with acute abdomen presenting as emergency at CMH and MH Rawalpindi were evaluated. Preoperatively X-ray chest PA view, in standing posture, was done in all cases and presence or absence of pneumoperitoneum noted. The patients were then followed by laparotomy to confirm or otherwise a perforation of duodenum. Only 30 patients were included in the study where duodenal perforation was confirmed per-operatively.
Results: Pneumoperitoneum on X ray chest PA view was found in 25(83.3%) out of 30 patients with duodenal ulcer perforation; The remaining 05 patients i.e. 16.67% did not show pneumoperitoneum.
Conclusions: X-ray chest is a helpful tool in diagnosing majority of patients with a perforated duodenal ulcer. However there is a significant number of patients where the clinical acumen of the doctor would help in an early diagnosis and prompt treatment.