ARE PERFORATED GASTRODUODENAL ULCERS RELATED TO HELICOBACTER-PYLORI INFECTION

The prevalence of Helicobacter pylori gastritis in 36 patients with a perforated ulcer undergoing endoscopy prior to or at least 2 months af ter perforation was 56%, intermediate between that of age and sex matc hed healthy blood donors (36%) who had measurement of circulating anti bodies to Helicobacter pylori and of ulcer patients without perforatio n matched for age, sex and ulcer location (86%). In the 20 patients wi th Helicobacter pylori gastritis, 8 had a history of peptic ulcer and 7 or 9 patients with a follow-up of at least 12 months and no preventi ve treatment had a symptomatic relapse. The group of patients without infection included 6 young patients (<40) who did not use non steroida l anti-inflammatory drugs and 10 older patients (<60):9 used non stero idal anti-inflammatory drugs and seven had a normal gastric mucosa on biopsy. One patient without Helicobacter pylori had a second perforati on, the only relapse in this group. We conclude that patients with per forated ulcers are a heterogeneous group with a recurrent ulcer diseas e mainly in patients with Helicobacter pylori.