A Study on Gastroduodenal Perforation in Young Adults (15-35 Years of Age) and Its Etiology

Madhanagopalan, R (2019) A Study on Gastroduodenal Perforation in Young Adults (15-35 Years of Age) and Its Etiology. Masters thesis, Madras Medical College, Chennai.


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BACKGROUND: Gastroduodenal perforations are most common among hollow viscus perforations, which are usually common among people above forties. Nowadays gastroduodenal perforations are in rise among young people, which may be attributed to many factors. This study aims to analyse and identify most common etiological factors among these young patients, which may vary from smoking and alcoholism to mental stress and nsaid abuse. This study aims to help young people at risk from developing gastroduodenal perforation by bringing out essential lifestyle modifications so that risk of developing perforations can be avoided. AIMS AND OBJECTIVES: 1. To analyse and identify most common etiological and risk factors among patients with gastroduodenal perforations in age group of 15 to 35 years at our institution. 2. To help young people at risk from developing gastroduodenal perforations by bringing out essential life style modifications. MATERIALS AND METHODS: A prospective and retrospective study was conducted at our “Institute of General Surgery” – Rajiv Gandhi Govt General Hospital & Madras Medical College, Chennai. Fifty cases of Gastroduodenal perforations were studied during the period of May 2017 to April 2018. The diagnosis was established by the Emergency Surgeon provisionally, based on the clinical presentation and supporting radiological evidence, in the ward, and definitive diagnosis established at the time of operation. Inclusion criteria: Age 15 to 35 years, Gastric or duodenal perforation. Exclusion criteria: • age < 15 years, • age > 35 years, • hollow viscus perforation other than gastroduodenal perforation. A proforma for study of etiological and risk factors for gastroduodenal perforations was used in patients in age group of 15 to 35 years diagnosed with gastroduodenal perforations. Socioeconomic status was measured using modified kuppusamy scale. Smoking habits were measured by categorizing patients as non smokers, daily use of less than and more than 10 cigarettes per day. Alcohol habits were measured by categorizing patients as non alcoholics, alcoholics taking less than 21 units and more than 21 units per week. H.pylori infectivity was diagnosed by taking intraop biopsies from ulcer edge and doing rapid urease test. NSAIDS use was measured as no use or increased intake of nsaids for 6 months before diagnosing with perforation. Psychological stress was measured using Cohen perceived stress scale with score of less than 13 categorised as negative for stress and more than 13 categorised as positive. Irregular food habits were measured by categorizing as 1 to 2 meals per day and taking 3 or more meals per day. CONCLUSION: Among young adults, gastroduodenal perforations were more common in 21 to 25 age groups. More common among male patients with male to female ratio of 6:1. Duodenal perforations were more common than gastric perforations. In duodenum, perforation was more common in first part. More common among lower socioeconomic groups. H.pylori was the most common etiological risk factor for gastroduodenal perforations among 15 to 35 age groups, followed by smoking and psychological stress. Role of alcohol, nsaids, steroids and irregular food habits as the causation of gastroduodenal perforations were little in my study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Gastroduodenal perforations, young adults, etiology, H.pylori, smoking, stress.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 03 Sep 2019 23:40
Last Modified: 06 Sep 2019 08:17
URI: http://repository-tnmgrmu.ac.in/id/eprint/11438

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