Perforated Peptic Ulcer in Rwanda: Epidemiology and Outcomes at a Tertiary Hospital in Kigali, Rwanda-A Retrospective Study|
Cyuzuzo, T.; Hakorimana, V.; Umugwaneza, G.; Uwitonze, M. C. & Mpirimbanyi, C.
INTRODUCTION: Perforated peptic ulcer (PPU) is a serious complication of Peptic Ulcer Disease (PUD).
This study aims to present the experience of managing patients with PPU over a multi-year period at the University
Teaching Hospital of Kigali (CHUK).
METHODS: A retrospective chart review was performed on all the charts of patients treated for PPU at CHUK from 2013-2017. Descriptive analysis, such as percentages and frequencies, were reported, and the relationship between variables
was assessed using chi-square.
RESULTS: Over the 66 months, 142 patients were admitted to CHUK with PPU. 81% were male and 19% were female. The
mean age was 40, with a range of 13 to 79 years. Abdominal distension (89%) and rebound tenderness and guarding (63%)
were the most common presenting findings. The mean duration of symptoms was four days and most of the patients
(70%) presented 24 hours after the onset of the symptoms. 96% of the patients had no associated comorbidities, and the
pre-pyloric site (32%), was the most likely to perforate. Intraoperatively, inflammatory (turbid) fluid (42%), was the most
common intra-abdominal fluid found. All patients underwent modified Graham’s repair. Sepsis (28%) and pneumonia
(20%) were the most common post-operative complications. The mortality rate was 28%. The risk of mortality increased
with the occurrence of any complication (p<0.001), and older age more than 61 (p=0.03).
CONCLUSION: Perforated peptic ulcers are not rare in Rwanda. PPU are associated with high morbidity and mortality. A
system-based initiative aiming to improve the management of these patients is indicated.
Peptic Ulcer; Epidemiology; Complications; Mortality