Perforated Duodenal Ulcer in High Risk Patients: Is Percutaneous Drainage Justified?

BACKGROUND: Conservative treatment was recommended as the treatment of choice in perforated acute peptic ulcer. Here, we adjunct percutaneous peritoneal drainage with nonoperative conservative treatment in high risk elderly patients with perforated duodenal ulcer. AIM: The work was to study the efficacy of percutaneous peritoneal drainage under local anesthesia supported by conservative measures in high risk elderly patients, according to the American Society of Anesthesiologists grading, with perforated duodenal ulcer. PATIENTS AND METHODS: Twenty four high risk patients with age >65 years having associated medical illness with evidence of perforated duodenal ulcer. RESULTS: The overall morbidity and mortality were comparable with those treated by conservative measures alone. CONCLUSION: In high risk patients with perforated peptic ulcer and established peritonitis, percutaneous peritoneal drainage under local anesthesia seems to be effective with least operative trauma and mortality rate.