Author(s)

Francois Adrien Morel Bokalli^1,2, Chi Fru McWright¹, Jerry Brown Njoh Aseneh¹, Takere Maseoli Mbachan¹, Ngomba Divine Mokake³, Jules Clément Assob Nguedia⁴, Marcelin Ngowe Ngowe⁵

¹Department of Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
¹Laquintinie Hospital, Douala, Cameroon.
³Department of Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
⁴Department of Biomedical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.
⁵Department of Surgery, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.

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.

Perforated Peptic Ulcers, Helicobacter pylori Infections, Clinical Features, Outcome

Bokalli, F. , McWright, C. , Aseneh, J. , Mbachan, T. , Mokake, N. , Nguedia, J. and Ngowe, M. (2020) Helicobacter Pylori Infections in Peptic Ulcer Perforations: A Retrospective Analysis in Two Referral Hospitals in Douala, Cameroon. Surgical Science, 11, 298-311. doi: 10.4236/ss.2020.1110032.