Clinical Study on Perforated Peptic Ulcers in the Elderly

Yozo Watanabe, Hidenori Tsumura, Toshiyuki Nakagawa, Kiyotaka Yabuki, Toshio Morimoto, Yoshiaki Okahara, Takanori Haba*, Takeshi Okubo*, Koichi Sato*, Michihiro Orihata*, Noburu Sakakibara*

Department of Surgery, Izunagaoka Hospital, Juntendo University School of Medicine
*First Department of Surgery, Juntendo University School of Medicine

This paper deals with a detailed analysis of perforated peptic ulcer patients over 70 years old to elucidate their clinical characteristics. The original subjects were 192 perforated peptic ulcer patients who received surgical operations at Juntendo University Hospital between 1966 and 1990. Of them, 20 were above 70 years of age. The incidence of such ulcers by time period and age was investigated in all 192 patients. Further, the background factors of the patients, preoperative complications, clinical findings, treatment, pathological findings, and mortality rate were investigated in patients aged above 70 years. The number of patients over 70 years old has been significantly increasing for 10 years and the average age of perforated peptic ulcer patients by time period has increased year by year. Of the 20 elderly peptic ulcer patients, 16 had duodenal ulcers. A history of ulcer was not noted in 14 and free air was detected in 17. Pathologically, 11 had acute ulcers. as surgical procedures, only 2 patients received simple closure, the remainder receiving, a radical operation. Four patients died after the operation. It is recommended that a diagnosis of perforated peptic ulcer by made early by making the most use of image diagnosis in the aged, because many of them have no history of ulcers and experience no severe subjective or objective symptoms.

Key words
perforated peptic ulcers in the elderly, clinical and pathological findings, surgical procedures for perforated peptic ulcer

Reprint requests
Yozo Watanabe Department of Surgery, Izunagaoka Hospital, Juntendo University School of Medicine
1129 Nagaoka, Izunagaoka-Machi, Tagata-Gun, Shizuoka, 410-22 JAPAN

Accepted
April 1, 1992

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