To assess changes in the pattern of admission and operation for duoden
al ulcer in Scotland, data recorded on Scottish Medical Records forms
for the years 1975-1990 were analysed. The overall admission rate fell
by 38 per cent from 157 to 98 per 100 000 population while the number
of operations per year dropped by 80 per cent from 2955 to 582. There
was a decline in perforation rate between 1975 and 1990 from 27 to 15
per 100 000 population. This general trend conceals a significant 93
per cent increase in the incidence of duodenal ulcer perforation among
women aged 65 years and above, from 21 per 100 000 in 1975 to 41 per
100 000 in 1990 (r = 0.76, P < 0.001). There was a general trend towar
ds a decline in haemorrhage rates, although this was significant only
for men aged 15-44 years (r= -0.73, P < 0.01) and 45-64 years (r= -0.6
3, P < 0.04).