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Article
April 1956

Metabolic Derangements Imperiling the Perforated Ulcer PatientVI. The Plan of Therapy

Author Affiliations

Boston
From the Department of Surgery, Harvard Medical School, and the Surgical Services, Massachusetts General Hospital.

AMA Arch Surg. 1956;72(4):571-582. doi:10.1001/archsurg.1956.01270220019003
Abstract

INTRODUCTION  The mortality rate from perforation of peptic ulcers has been high and continues so unremittingly. In this hospital during the period from 1940 to 1952, one in every 11 patients admitted with a perforated ulcer succumbed.1 This represents an appreciable improvement over the 44% mortality observed prior to 19162 and the 27% rate for the period between 1916 and 1940,3 but in a surgical condition as common as this it seems unreasonable that so many cases should have had a fatal outcome. Comparable figures are reported from other hospitals.*When the possible causes of the high mortality are examined, it becomes apparent that better management of the metabolic derangements associated with the condition should reduce the mortality more effectively than altering the type of operation. Good judgment in selecting the operative treatment to fit the mechanical problem involved in each case is not to be ignored,

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