Peptic Ulcer Perforation: An Enigma Since Antiquity

Peptic ulcer disease (PUD) is a serious medical condition. The perforation of peptic ulcers (PPU) causes a steep rise in mortality and morbidity. It accounts for 70% of deaths associated with PUD. More than 60% of perforations occur in the anterior wall of the duodenum, while 20% of it is in the antrum. The gastric ulcer perforation contributes to approximately 20% and is in lesser curvature. The risk factor includes non-steroidal anti-inflammatory drugs (NSAID), Helicobactor pylori (H. Pylori), smoking, alcoholism, Corticosteroid, and stress are some of the risk factors. There is a change in the epidemiology of PUD recently. The improvement is remarkable and is due to improved socio-economic status, identification and treatment of Helicobacter pylori, and introduction of proton pump inhibitors. The H pylori infection remains one of the most important causes of PUD and its complications like PPU. The reason for reviewing and writing this paper is to evaluate the most common ideas on the treatment of peptic ulcer perforation, opinion on conservative treatment, and surgical treatment options.