A Clinical Study of Peptic Ulcer Perforation in Young Patients

Vollständiger Abstract

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Background: Peptic ulcer perforation is a life-threatening surgical emergency traditionally associated with older adults, but its occurrence in young patients is increasingly recognized. Young adults may have distinct risk factors, clinical characteristics, and outcomes. Early diagnosis and prompt surgical intervention are essential to reduce morbidity and mortality. Aim: To evaluate the demographic characteristics, etiological factors, clinical presentation, surgical management, postoperative outcomes, and follow-up of patients younger than 30 years presenting with peptic ulcer perforation. Materials and Methods: This planned observational cohort study was conducted in the Department of General Surgery, Narayana Medical College and Hospital, Nellore, from June 2024 to December 2025. Thirty patients younger than 30 years with clinically and radiologically diagnosed peptic ulcer perforation, confirmed intraoperatively, were included. Demographic details, risk factors, clinical findings, investigations, site and size of perforation, degree of contamination, operative procedure, postoperative complications, hospital stay, ulcer healing, recurrence, and mortality were assessed. Results: Among 30 patients, 21 (70%) were males and 9 (30%) were females. The majority belonged to the 25–30-year age group (46.67%). Smoking was the most common risk factor, reported in 70% of patients, followed by alcohol use (40%), H. pylori positivity (36.67%), and NSAID use (23.33%). Abdominal pain and abdominal rigidity were present in all patients, while vomiting occurred in 63.33%. Preoperative shock was present in 10%, and free gas on X-ray was detected in all patients. Duodenal perforation was predominant (76.67%), while gastric perforation accounted for 23.33%. All patients underwent Graham’s omental patch repair, with a mean operative duration of 73.5 ± 15.15 minutes. Postoperative pain showed significant improvement from a mean VAS score of 7 ± 1.74 on postoperative day 1 to 3.47 ± 1.25 on day 7 (p