ABSTRACT
This chapter describes the common causes of peptic ulcer disease. These include Helicobacter pylori, non-steroidal anti-inflammatory drugs, acute systemic illness, cigarette smoking, and chronic disease. The chapter discusses the complications of peptic ulceration: perforation, haemorrhage, gastric outlet obstruction, and recurrent ulceration. During the diagnosis of a perforated peptic ulcer, the patient requires an urgent laparotomy and oversewing of the ulcer. The priorities would be to resuscitate the patient adequately and to prepare them for theatre. This preparation should include the following: intravenous access and crystalloid fluids, adequate analgesia, nasogastric tube, urinary catheter, and intravenous antibiotics. It is also essential to obtain informed consent from the patient and to inform the anaesthetist and theatre sister. After optimal resuscitation and obtaining consent, the patient is prepared for theatre under general anaesthetic in the supine position. The chapter also discusses the criteria for operative management of a bleeding peptic ulcer.
