The prevalence of Helicobacter pylori in perforated peptic ulcer disease

Background: Although the role of Helicobacter pylori infection in noncomplicated peptic ulcer disease has been definitively established, the precise relationship between the organism and ulcer complications is doubtful. Recurrent ulcer disease after peptic ulcer perforation mainly occurs in patients with H. pylori infection, which suggests that the microorganism plays an important role in this complication. Methods: This observational study was conducted in the Department of General Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of January 2013 to December 2013 and included 75 subjects who underwent exploratory laparotomy for peptic ulcer perforation. The tests used for the diagnosis of H. pylori are mucosal biopsy at the time of surgery, Rapid urease test (RUT), Stool antigen test. Results: In this study, H. pylori infection was found to be present in 61% of these patients as detected by biopsy. There were 66 males and 9 females. Infection with H. pylori is almost universal in patients aged more than 70 years. Conclusions: In the Indian context patients presenting with perforation should be tested for infection with H. pylori utilizing a gastric antral mucosal biopsy taken at the time of operation for histological analysis and eradication therapy should be advised to all those who are found positive.