Abstract:
BACKGROUND: Perforation of peptic ulcer (PPU) is the most morbid complication of peptic ulcer disease (PUD) with scant
recent reports from sub-Saharan Africa. The aim of this study was to describe a PPU series from a single centre in South
Africa and contrast the findings with other recent reports from sub-Saharan Africa.
METHODS: A retrospective study of PPU at Kalafong Hospital in Pretoria was performed. The relationship of patient
demographics, risk factors, ulcer pathology and severity scores to mortality were analysed. Recent similar reports from
sub-Saharan Africa were reviewed and the findings compared to the current study and findings from high income countries
(HIC).
RESULTS: The study comprised 121 patients. The majority were black men with an average age of 46.6 years, with few comorbidities. A large proportion of patients admitted to risk factors and most presented to hospital 48 hours after the onset
of symptoms. The majority (71%) of the perforations occurred in the stomach. The patient sex, age, risk factors and the
mortality at 4% were similar to other African studies, although perforations were mainly duodenal in most of the African
studies. The median age of patients in the East African studies was lower by 13 years. Patients in HIC series of PPU were
older, more likely to be female, have duodenal perforations and a higher mortality than in the African series.
CONCLUSION: Patients were mostly smokers, presented late to hospital and had gastric perforations. The findings of low
mortality and male predominance concurred with those of other sub-Saharan African reports and were the opposite of
trends in HIC.
