Pattern of peptic ulcer disease in Zaria, Nigeria.

The pattern of peptic ulcer disease in Zaria has been that of an increasing frequency of perforation, reaching a peak of 45% by 1983. In a retrospective study of 88 consecutive patients managed surgically for duodenal and gastric ulcers between 1984 and 1995, 41% had gastric outlet obstruction and only 17% had perforation. However, the ratio of perforated duodenal ulcer: perforated gastric ulcer has more than doubled from 2.6:1 to 6.5:1. Until now the pattern of peptic ulcer disease in northern Nigeria was different from that in southern Nigeria and most parts of black Africa but this review suggests a reversion to the pattern in these other places. Though these findings may be due to the effects of a changing economy, they may represent a change in the intrinsic behaviour of peptic ulcers in our environment. Ulcer perforation continues to carry a high mortality and truncal vagotomy and drainage remains the surgical treatment of choice for duodenal and gastric ulcers in our institution.