No previous studies have investigated H. Pylori eradication in patients with perforated duodenal ulcer.
Dr V Kate and colleagues assessed the prevalence of H. Pylori after simple closure of a perforated duodenal ulcer. The research team also evaluated the effect of H. pylori eradication on the outcome of perforated duodenal ulcer treatment.
202 patients undergoing closure of a perforated duodenal ulcer were followed prospectively for 2 years after surgery. A second group of 60 patients were reviewed retrospectively 5 years after ulcer closure.
Patients in both the prospective and retrospective groups were screened for H. Pylori infection prior to surgery and at several times during follow-up. H. Pylori prevalence was found to be no greater in patients with perforated duodenal ulcer than in controls.
After ulcer closure patients received either ranitidine alone or quadruple therapy for H. Pylori eradication.
Both the prospective and retrospective groups showed a positive correlation between persistence of H. Pylori infection and the incidence of residual or recurrent ulcers.
|H. Pylori eradication should be routine in patients with a perforated duodenal ulcer.|
|British Journal of Surgery|
Successful eradication of H. Pylori reduced the incidence of ulcer recurrence.
Dr Kate recommends, "Eradication of H. Pylori should be attempted in all patients with a perforated duodenal ulcer and H. Pylori infection."