Helicobacter pylori infection and duodenal ulcer perforation

Abstract

Helicobacterpylori infection is recognised as a major cause of peptic ulcer disease. Nevertheless, its association with duodenal ulcer perforation remains controversial until more recently. In the past, during emergency operation for patients with duodenal ulcer perforation, the addition of an acid reduction procedure was advocated to reduce the risk of recurrent ulceration. If the underlying ulcer is caused by H. pylori, however, acid reduction procedure may not be necessary. Recent evidence suggested that recurrent ulcer disease in patients with a history of perforated duodenal ulcer is related to H. pylori infection. Simple closure without acid reduction procedure for patients presenting with perforated duodenal ulcer is therefore recommended. Eradication therapy should be given to those patients who are subsequently found to have H. pylori infection. This review summarises the current knowledge of H. pylori infection and duodenal ulcer perforation.