Surgical Treatment of Peptic Ulcer Perforation in the Antibiotic Era: Outcomes and Recurrence Patterns at University of Abuja Teaching Hospital

Peptic ulcer perforation remains a common surgical emergency in Nigeria despite advances in Helicobacter pylori eradication therapy and proton pump inhibitor use. The long-term outcomes and recurrence patterns following surgical repair in the contemporary antibiotic era have not been studied at Nigerian teaching hospitals. This analytical study examines surgical outcomes and recurrence patterns following emergency repair of perforated peptic ulcer at the University of Abuja Teaching Hospital (UATH), Federal Capital Territory, North Central Nigeria, from 2018 to 2022. A retrospective cohort of 110 patients who underwent emergency laparotomy for perforated peptic ulcer was followed up for 36 months postoperatively. Operative technique, H. pylori testing, eradication therapy adherence, and ulcer recurrence rates were analyzed. Ninety-day mortality was 8.2%. Simple closure with omental patch was performed in 93% of cases. H. pylori testing was performed in only 41% of patients postoperatively, and eradication therapy completion was documented in 71% of those tested. Ulcer recurrence within 36 months occurred in 22%, with non-testing and non-eradication as the strongest predictors. The study strongly recommends universal postoperative H. pylori testing, structured eradication therapy protocols, and patient education on NSAIDs and alcohol avoidance in North Central Nigeria. Keywords: peptic ulcer perforation, H. pylori, omental patch, recurrence, Abuja