Risk factor for perforated duodenal ulcer in sulaemania city

  • Taher Abdullah Hawrame M.B.Ch.B., D.S., (C.A.B.S.) Assistant professor – University of Sulymaniah.
  • Zanko Sherko Fathalah M.B.Ch.B., D.G.S., F.I.B.M.S. General Surgery – Koya General Hospital.
  • Muhammed Abulrahman Mahmood M.B.Ch.B., D.S. General Surgery – Azady General Hospital.
Keywords: Perforated duodenal ulcer, Nonsteroidal antiinflammatory drugs, Smoking, H. Pylori, Proton pump inhibitors and antisecretary dugs


Background and Objective: This prospective study was to evaluate the probable risk factors for perforation of duodenal ulcer, highlighting any prevalent one in the occurrence of perforation in Sulaemania city. The study was designed to be performed on patients with perforated duodenal ulcer attending the emergency department in Sulaemania teaching hospital over the period of this study.

Method: This study was conducted between 1st of March 2009 till the 1st of October 2009 involving 50 patients with perforated duodenal ulcer attended the emergency department in Sulaemania teaching hospital. A number of probable risk factors for the patients were studied.

Results: Out of 50 patients, 41(82%) were males, 9(18%) were females and the male to female ratio was (4.5:1), about 32% of the patients were more than 60 years old. Patients described themselves as having a nervous personality were 31(62%) and the number of patients lived in city center were 28(56%). Smoker patients were 36(72%) and 33 patients (66%) had a history of NSAIDs ingestion.

Conclusion: Smoking, NSAIDs ingestion, sex, age and stress played a major role as risk factors in the occurrence in duodenal ulcer perforation. There is a seasonal variation in incidence of perforation including high incidence during spring and autumn.


Gumma KA et al. The effect of fasting in Ramadan. British journal of nutrition, 1978; 40:573-81.

Al-Kaabi S et al. Effect of Ramadan fasting on peptic ulcer disease. Indian journal of gastroenterology, 2004; 23:35-6.

Donderici O et l. effect of Ramadan on peptic ulcer complications. Scandinavian journal of gastroemnterology, 1994; 20:603-6.

Peter J.morris, WilliamC.Wood. Peptic ulcer. Oxford Textbook of Surgery, 2nd edition, 2000; 215.

Abu Farsakh NA. Risk factors for duodenal ulcer disease. Saudi medical journal, 2002, 23:168-72.

Sakhri J, Sabri Y et al.Treatment of perforated duodenal ulcer. Tunis- Med, 2000; 78:494-498.

Bonder B, Harrington ME, Kim I. Multifactorial analysis of mortality and morbidity in perforated peptic ulcer disease. Surg Gynaecol Obstet 1990, 171:315-21.

Jain A; er al. Risk factors for duodenal ulcer in north India. Trop Gasroenterol 1999 Jan- Mar ; 20 (1) :36-9.

Voutilainen M; et al. Impact of non-steroidal anti-inflamatory drug and aspirin use on the prevalence of dyspepsia and uncomplicated peptic ulcer disease. Scand J Gasroenterol. 2001 Aug; 36(8): 871-21.

Bjorkman DJ. Current status of non-steroidal anti-inflamatory drug use in the United States: risk factors and frequency of complications. Am J Med.1999 Dec 13; 107(6a): 3s-8s; discussion 8s-10s.

Aldoori VVH, et al. A prospective study of alcohol, smoking, caffeine and the risk of duodenal ulcer in men. Epidemiology 1997; 8:420- 424

Elta GH, et al. comparison of coffee intake and coffee- induced symptoms in patients with duodenal ulcer, non ulcer dyspepsia and normal controls. Am J Gastroenterol 1990; 85: 1339- 1342.

Ahmed ME, Al Knawy BA, Al Wabel AH, Foli AK. Duodenal ulcer and helicobacter pylori infection at high altitude; experience from southern Saudi Arabia. Can J Gasroenterology. 1997; 11: 313-316.

Estwood GL. Is smoking still important in the pathogenesis of peptic ulcer disease? J clin Gastroenterology. 1997; 25 Supp 1-7.

Al-Maari MA et al. Does peptic ulcer perforation occure more frequently in Ramadan? Paper presented at the First International Congress on Health and Ramadan, 19-22 JAN.,1994, Casablanca.

Andypotroianu, Marcelode souse Marques. Seasonal incidence of perforation and sever bleeding of peptic ulcer. Dig. Surg, 1993; 10: 69-71.

Jarczyk G, Jedrzejezyk W. Epidemiologic and demographic aspects characteristic of patients with perforated duodenal ulcer. Pol Tyg Lek, 1996; 14: 215.

Davidson. Blood disorders, Christopher, Chilvers, Boon, Colledge (editor), principles and practices of medicine, Edinburgh, 2002; 19th edition, 912.

How to Cite
Hawrame, T., Fathalah, Z., & Mahmood, M. (2018). Risk factor for perforated duodenal ulcer in sulaemania city. Zanco Journal of Medical Sciences (Zanco J Med Sci), 14(3), 61 - 66. Retrieved from https://zjms.hmu.edu.krd/index.php/zjms/article/view/477
Original Articles