Helicobacter Pylori Infections in Peptic Ulcer Perforations: A Retrospective Analysis in Two Referral Hospitals in Douala, Cameroon

• 作者: Chi Fru McWright Francois Adrien Morel Bokalli Jerry Brown Njoh Aseneh Jules Clément Assob Nguedia Marcelin Ngowe Ngowe Ngomba Divine Mokake Takere Maseoli Mbachan
• 来源期刊: 外科学(英文)
• 学科: 医学
• 关键词: Perforated Peptic Ulcers Helicobacter pylori Infections Clinical Features OUTCOME
• 年，卷（期）: 2020,（10）
• 页码范围: 298-311
• 页数: 14页
• 分类号: R57

摘要

<strong>Background:</strong> Perforations are major complications of peptic ulcer disease and surgical emergencies with important mortality and morbidity. <em>Helicobacter pylori (H. pylori)</em> has been identified as one of the commonest factors associated with peptic ulcer disease. However, little is known about its implication in cases of perforations in Cameroon. We aimed to determine the frequency of <em>Helicobacter pylori</em> infections in cases of perforated peptic ulcers, describe clinical features and outcomes of these cases in Cameroon. <strong>Method:</strong> A hospital-based retrospective cross-sectional study was conducted through the review of patients’ records admitted for peptic ulcer perforations in Laquintinie and Douala General Hospitals over a period of 5 years (January 2014 - December 2018). We defined <em>H. pylori</em> infection as;positive result on tissue biopsy at time of surgery. We used SPSS version 23.0 to analyse data and set an alpha value at P = 0.05. <strong>Results:</strong> We reviewed 115 cases of peptic ulcer perforation, with a mean age of 40 years and sex ratio (M:F) of 5:1. All patients underwent emergency laparotomy, 48 (41%) cases had a biopsy report and the prevalence of <em>H. pylori</em> infection in these cases was 47.9 %. Smoking, alcohol consumption and Non-Steroidal Anti-inflammatory Drugs (NSAIDs) use, were not associated with peptic ulcer perforation. The morbidity was at 43.7% and mortality at 14%. Mortality was increasing with a higher Mannheim Peritonitis Index score (OR: 23.51, 95% CI: 4.197 - 143.003, P-value: 0.000). <strong>Conclusion:</strong> We observed a high prevalence of <em>H. pylori</em> infection in patients with peptic ulcer perforations. We recommend systematic <em>H. pylori</em> screening in cases of perforations and that larger studies should be carried out to evaluate the association of <em>H. pylori</em> infection with peptic ulcer perforation in Sub-Saharan Africa.