2006 Volume 39 Issue 6 Pages 643-648
Introduction: The purpose of this study was to evaluate the indications and usefulness of conservative treatment of perforated duodenal ulcer (PDU).Patients and Methods: A total of 80 patients with PDU between April 1997 and March 2004 were classified to a conservative treatment group and an operative therapy group, and the two groups were compared. The following criteria are generally recommended for conservative treatment: 1) generally stable condition; 2) no or only slight localized fluid collection observed by ultrasonographyor computed tomography; and 3) after 1999 less than 2cm gastrografin leakage during upper gastroduodenography (UGI) was added.Results: Among the 80 patients, 46 were initially treated conservatively, five of whom developed an abscess and 6 were converted to surgery, yielding a completion rate of 87%(40/46). The conservative treatment group was significantly younger and had shorter hospital stays than the operative therapy group. The addition of UGI was followed by there a further increase in the completion rate of the conservative treatment, and no abdominal abscesses developed.Conclusions: Our new criteria, including the UGI findings, seem useful for the indications for conservative treatment of the patients with PDU.
