Treatment of Patients with Acute Perforation of Peptic Ulceration

Abstract
Interest and controversy in the treatment of patients with perforated peptic ulcer have been reawakened by the suggestion of, first, nonoperative treatment of such patients by suction and antibiotics, and, second, by primary gastric resection1,2,8 to replace simple operative closure. In an attempt to evaluate these suggestions, a review of 98 patients with perforated peptic ulcer seen at the Milwaukee County Hospital in the 60 months from Jan. 1, 1951, to Dec. 31, 1956, was undertaken. The youngest was 23 and the oldest 83 years of age. Fifty-three per cent were 50 years of age or older (Fig. 1). Of the patients 79% were men and 21% were women (Fig. 2). Seventy-six ulcers were reported as duodenal, and twenty-one as gastric, by the operating surgeon. In addition, there were two free perforations of jejunal ulcers which occurred subsequent to perforation of a duodenal ulcer and gastric resection or posterior