High prevalence ofHelicobacter pyloriinfection in duodenal ulcer perforations not caused by non‐steroidal anti‐inflammatory drugs

摘要

AbstractThere has been controversy regarding the relationship betweenHelicobacter pyloriand perforated peptic ulcer, which is known to have a high recurrence rate if only simple patch repair is performed. The aim of this study was to evaluate the association betweenH. pyloriinfection and intake of non‐steroidal anti‐inflammatory drugs (NSAIDs) in patients with perforated duodenal ulcers. Of the 73 patients recruited over a 16‐month period, 51 (70 per cent) had evidence ofH. pyloriinfection by intra‐operative gastroscopy and antral biopsies. The infection rate rose to 80 per cent if NSAID users were excluded. TheH. pylori‐infected group was significantly younger (mean 47.6versus62.5 years), with a male preponderance (49 of 51versus14 of 22 patients), and had significantly less NSAID consumption (three of 51versusten of 22) and more prolonged dyspepsia (40 of 51versusten of 22), compared withH. pylori‐negative patients.H. pyloriinfection probably plays an important role in the causation of non‐NSAID‐induced duodenal ulcer perforation. Whether eradication of the bacteria can alleviate the strong ulcer diathesis in this subgroup of pati