A Clinical Study on Helicobacter Pylori Prevalence in Peptic Ulcer Perforation

Background: Peptic ulcer disease (PUD) results from an imbalance between mucosal defense and aggressive factors such as acid and pepsin. Although most cases respond to medical management, complications like perforation remain life-threatening and require surgical intervention. Helicobacter pylori (H. pylori) has been established as a major etiological factor in PUD, but its role in perforated ulcers remains controversial, particularly in developing regions. Aim: To determine the prevalence of Helicobacter pylori infection in patients with peptic ulcer perforation and assess its association with demographic and lifestyle factors. Methodology: A prospective hospital-based study was conducted on 50 patients aged 15–60 years diagnosed intraoperatively with peptic ulcer perforation at Narayana Medical College, Nellore, between January 2023 and June 2024. Biopsies from the ulcer edge and surrounding mucosa were obtained and tested for H. pylori using Giemsa staining and Rapid Urease Test. Data on age, gender, risk factors, and clinical presentation were analyzed. Results: Of the 50 patients, 46 (92%) were male and 4 (8%) were female, with the highest incidence in the 24–42year age group. Duodenal perforations (84%) predominated over gastric (16%). H. pylori was detected in 32 patients (64%), with 52% in duodenal and 12% in gastric perforations. Major risk factors included smoking (82%), alcohol use (82%), and NSAID intake (22%). Conclusion: H. pylori infection remains a significant etiological factor in peptic ulcer perforation, particularly in duodenal ulcers among middle-aged males with concurrent smoking and alcohol habits. Routine intraoperative biopsy and postoperative eradication therapy are recommended to reduce recurrence and complications.