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Original Research Article Background: Conservative treatment is an alternative method of surgical treatment for the management of perforated peptic ulcer diseases. Objective: The objective of the study is to recommend safe and effective treatment in selected cases of peptic ulcer perforation under strict supervision as an alternative to surgery. Method: This prospective study was conducted at Surgery Department of M. Abdur Rahim Medical College Hospital, Dinajpur, Bangladesh for a period of July 2008 to July 2009. Hundred cases were selected by special inclusion and exclusion criteria. Results: All patients were presented with acute upper abdominal pain, most were in their fourth decade and came to the hospital around twenty four hours of their onset of pain. Diagnosis was made on clinical grounds and confirmed by radiological and imaging examinations. Resuscitative measures were taken in all cases in the form of IV fluid, nasogastric suction, antibiotics and analgesics. The study was designed to treat all the patients conservatively and accordingly all were given conservative regimen up to 24 hours. There after they were assessed clinically. Great deterioration was found in 12 patients and 18 patients showed no improvement who were operated immediately. Conservative measures were continued for 70 patients who responded smoothly with few minor complications. The mortality was 6.33% in the cases treated operatively after failing conservative management. No mortality was found in conservatively treated group. Conclusion: Conservative treatment is the safe and secure way as an alternative to surgery for the peptic ulcer perforation. It involves preoperative risk stratification, laparoscopic care and a greater role for non-operative treatment. If we consider surgical complications and patient compliance, non-operative treatment is a beneficial approach for treating perforated patients with peptic ulcer and also under strict supervision it will be effective and workable as well.

Accumulative Study of the Value of Conservative Treatment in Selected Cases of Peptic Ulcer Perforation