Incidence And Risk Factors Of H Pylori Infection In Cases Of Emergency Surgery Done For Gastroduodenal Perforation

Abstract

Introduction: Peptic ulcer disease (PUD) remains a major global health issue, with perforation representing one of its most serious complications. Helicobacter pylori infection is a key etiological factor in ulcerogenesis; however, its precise role in gastroduodenal perforation remains uncertain. This study aimed to evaluate the prevalence of H. pylori infection in patients with perforated peptic ulcers and to analyze associated clinical outcomes.

Materials and Methods: A prospective cross-sectional study was conducted at Adichunchanagiri Institute of Medical Sciences, Adichunchanagiri University, Karnataka, from July 2023 to December 2024. A total of 48 patients aged 18–70 years undergoing emergency laparotomy for perforated peptic ulcer were enrolled. Clinical, demographic, and perioperative data were collected. Intraoperative biopsy specimens were examined histopathologically for H. pylori. Data were analyzed using SPSS version 26, with Chi-square test applied to assess associations; p < 0.05 was considered significant.

Results: Among 48 patients, 87.5% were male and the majority (31.3%) were aged 41–50 years. Vomiting (85.4%), severe abdominal pain (35.4%), and fever (60.4%) were common presenting features. Radiological evidence of gas under the diaphragm was observed in 95.8% of cases. Histopathology confirmed H. pylori positivity in 66.7% of patients. No statistically significant associations were found between infection status and prior anti-ulcer therapy, eradication treatment, analgesic use, or endoscopy history (p > 0.05).

Conclusion: H. pylori infection was highly prevalent among patients with perforated peptic ulcers, highlighting its importance in disease pathogenesis. Lack of association with prior therapy suggests reinfection, incomplete eradication, or resistance. Routine screening, eradication protocols, and public health measures are essential to reduce disease burden.