ACUTE FREE PERFORATION OF PEPTIC ULCER: COMPLICATION OF ULCER DIATHESIS

Abstract

THE PLICATION of an acute free perforation of a peptic ulcer is one of the simpler surgical procedures that for a long time has been regarded as a life-saving operation. The morbidity and the mortality rates associated with most surgical procedures have decreased decade by decade since they were first employed commonly. A review of the recent clinical reports from 1946 to 1952¹ (Table 1) reveals that there has been little improvement with this procedure over the past 30 years. In studying our 19-year experience at the New York Hospital-Cornell Medical Center, we have become interested in finding reasons for this seeming lack of progress, with the hope that measures might be devised to improve our results. CLINICAL MATERIAL One hundred thirty-six pavilion patients had 139 perforations treated by plication in 19 years. We have not included subacute perforations (penetrating ulcers), perforations into adjacent structures, or carcinomas with perforations