Perforated Peptic Ulcer Disease at Kenyatta National Hospital, Nairobi.

Background: Published reports on perforated peptic ulcers indicate increasing rates for the elderly, those chronically ill and females. Our local observations are at variance. This study analysed patients treated for peptic ulcer perforations at the Kenyatta National Hospital between January 2005 and December 2006.
Methods: Clinical charts for patients admitted and treated for perforated peptic ulcer disease were reviewed. Data sought included patient demographic data, clinical presentation, and time from onset of symptoms to treatment, operative findings and treatment complications. The determinants of post-operative complications were evaluated using univariate analysis.
Results: Forty four patients with perforated ulcers were admitted and treated over a two year study period. Twenty eight were analyzed (retrieval rate 63.6%). Males (86.2%) and those 35 years of age and younger (57.1%) predominated. Alcohol, smoking and prior use of non steroidal anti inflammatory drugs were respectively documented in 39.3%, 39.3% and 10.7% of patients. The complication rate was 25%. Four patients died. The factors significantly related to complications was treatment delay (p=0.007) and acute perforation (0.027)
Conclusion: Perforated peptic ulcer disease is a disease of young males. Efforts to reduce delay in presentation in this population may reduce the complications.