Helicobacter Pylori Infections in Peptic Ulcer Perforations: A Retrospective Analysis in Two Referral Hospitals in Douala, Cameroon
Open Access
- 1 January 2020
- journal article
- research article
- Published by Scientific Research Publishing, Inc. in Surgical Science
- Vol. 11 (10), 298-311
- https://doi.org/10.4236/ss.2020.1110032
Abstract
Background: Perforations are major complications of peptic ulcer disease and surgical emergencies with important mortality and morbidity. Helicobacter pylori (H. pylori) has been identified as one of the commonest factors associated with peptic ulcer disease. However, little is known about its implication in cases of perforations in Cameroon. We aimed to determine the frequency of Helicobacter pylori infections in cases of perforated peptic ulcers, describe clinical features and outcomes of these cases in Cameroon. Method: A hospital-based retrospective cross-sectional study was conducted through the review of patients’ records admitted for peptic ulcer perforations in Laquintinie and Douala General Hospitals over a period of 5 years (January 2014 - December 2018). We defined H. pylori infection as; positive result on tissue biopsy at time of surgery. We used SPSS version 23.0 to analyse data and set an alpha value at P = 0.05. Results: We reviewed 115 cases of peptic ulcer perforation, with a mean age of 40 years and sex ratio (M:F) of 5:1. All patients underwent emergency laparotomy, 48 (41%) cases had a biopsy report and the prevalence of H. pylori infection in these cases was 47.9 %. Smoking, alcohol consumption and Non-Steroidal Anti-inflammatory Drugs (NSAIDs) use, were not associated with peptic ulcer perforation. The morbidity was at 43.7% and mortality at 14%. Mortality was increasing with a higher Mannheim Peritonitis Index score (OR: 23.51, 95% CI: 4.197 - 143.003, P-value: 0.000). Conclusion: We observed a high prevalence of H. pylori infection in patients with peptic ulcer perforations. We recommend systematic H. pylori screening in cases of perforations and that larger studies should be carried out to evaluate the association of H. pylori infection with peptic ulcer perforation in Sub-Saharan Africa.Keywords
This publication has 20 references indexed in Scilit:
- Helicobacter pylori and precancerous conditions of the stomach: the frequency of infection in a cross-sectional study of 79 consecutive patients with chronic antral gastritis in Yaoundé, CameroonPan African Medical Journal, 2015
- Prevalence and Risk Factors Associated with Post Operative Infections in the Limbe Regional Hospital of CameroonThe Open Surgery Journal, 2014
- Helicobacter pylori in gastroduodenal perforationMedical Journal of Dr. D.Y. Patil University, 2014
- The challenge of intra-abdominal sepsisInternational Journal of Surgery, 2013
- Epidémiologie de l’infection à Helicobacter Pylori à Yaoundé: de la particularité à l’énigme AfricainePan African Medical Journal, 2013
- Complications of Peptic Ulcer DiseaseDigestive Diseases, 2011
- Multicentre trial of a perioperative protocol to reduce mortality in patients with peptic ulcer perforationBritish Journal of Surgery, 2011
- Clinical profile and outcome of surgical treatment of perforated peptic ulcers in Northwestern Tanzania: A tertiary hospital experienceWorld Journal of Emergency Surgery, 2011
- Helicobacter pylori eradication prevents recurrence after simple closure of perforated duodenal ulcerJournal of Gastroenterology and Hepatology, 2007
- Helicobacter pylori antigens in the faeces of asymptomatic children in the Buea and Limbe health districts of Cameroon: a pilot studyTropical Medicine & International Health, 2004