PREVALENCE OF HELICOBACTER PYLORI INFECTION IN PERFORATED PEPTIC ULCER DISEASE PRESENTING TO A TERTIARY CARE HOSPITAL

Abstract

Objective:  To determine the prevalence of Helicobacter pylori (H. pylori) infection among patients presenting with perforated peptic ulcer disease and to evaluate its association with demographic and clinical risk factors at a tertiary care hospital.

Study Design:  Cross-sectional study.

Setting:  Department of General Surgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi.

Period:  January 2025 to April 2025.

Material & Methods:  A total of 95 individuals aged 20-60 years underwent emergency surgery for a perforated peptic ulcer and were recruited through non-probability consecutive sampling. Data about the demographics and characteristics of patients, including NSAID use, history of peptic ulcer disease, residence, and co-morbidities (i.e., hypertension, diabetes, and smoking), were documented on a predesigned proforma. A stool antigen test was performed to detect H. pylori, and a positive result was considered evidence of H. pylori infection. Data were analyzed in SPSS version 26, and the chi-square test (and Fisher's exact test when the chi-square test was inapplicable) was used for categorical data and the Mann-Whitney U test/independent samples t-test for quantitative data, with a value of p < 0.05 considered statistically significant.

Results:  Among the 95 patients, 48 (50.5%) were H. pylori infection-positive. The infection was significantly higher among patients aged 20 - 40 years (95.6% vs 10.0% among patients aged 41 - 60 years), among those with duodenal perforation (100% vs 0% among those with gastric perforation), among non-NSAID users (97.7% vs 11.5%), non-hypertensives (97.7% vs 11.5%), non-diabetics (69.6% vs 0%), those residing in rural areas (71.4% vs 34.0% among residents of urban areas), and those with a shorter duration of illness (p < 0.001 for all). The infection was not significantly associated with gender and smoking (p = 0.461 for both).

Conclusion:  For this population, H. pylori infection is common in patients who have recently undergone surgery for perforated peptic ulcers. There is H. pylori positivity with younger age, rural residency, shorter disease duration, and perforation at the duodenal site. There is more H. pylori-negative perforation with NSAID use, hypertension, and diabetes mellitus. This shows that there are two main different causes for perforation for this particular subject group.