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February 1963

Acute Perforated Peptic Ulcer: Treatment by Primary Definitive Surgery

Author Affiliations

From the Department of Surgery, Medical College of Virginia.

Arch Surg. 1963;86(2):230-232. doi:10.1001/archsurg.1963.01310080054012

Opinions vary concerning the optimum treatment of acute gastroduodenal peptic perforation.4,6,7,9,10,11,13,15,16,19,20 Not only does one have to consider the treatment of the acute abdominal catastrophe, but one should also bear in mind the prevention of future ulcer symptoms and dangerous complications. The most controversial unanswered question is whether the perforation per se is sufficient evidence of intractability to justify primary gastrectomy as the treatment of choice.

To gain information pertinent to this question a study has been made of 154 cases of gastroduodenal perforation treated at the Medical College of Virginia Hospitals since 1952. Those patients surviving simple closure have been carefully followed in an effort to ascertain the number who have developed recurrent ulcer symptoms and complications. Results therefrom indicate that a high percentage of patients undergoing simple plication subsequently develop disabling ulcer symptoms. Our findings also indicate that after simple plication, patients in whom preexisting ulcer symptoms