{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:11Z","timestamp":1787017091072,"version":"build-2736575974"},"reference-count":17,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1993,10]]},"abstract":"<jats:p>Most patients with chronic duodenal ulcer disease have Helicobacter pylori infection and eradicating it considerably reduces the relapse rate. The prevalence of H pylori in 80 patients (mean age = 52 years, range 17-85) presenting with acute perforated duodenal ulcer was examined and compared with age and sex matched hospital control patients. H pylori state was assessed by serum anti-H pylori IgG (Helico-G kit, Porton) using a titre of 18 or less as negative with a specificity of 89% and sensitivity of 88%. Only 47% of the perforated duodenal ulcer patients were positive for H pylori and this was similar to the value of 50% in the controls. In 51 of the perforated duodenal ulcer patients 14C-urea breath tests were also performed 4-10 weeks after surgery and this confirmed that only 49% were positive for H pylori. None of these patients had received perioperative drugs that might have eradicated the infection. The H pylori positive and H pylori negative perforated duodenal ulcer patients were similar with respect to age (53, 51), smoking (84%, 83%), and consumption of more than 15 units of alcohol per week (42%, 38%). Duodenal ulcer disease had been diagnosed before acute perforation in only 24% of those with H pylori and also 24% of those without the infection. Regular non-steroidal anti-inflammatory drug (NSAID) use was common in both those with (44%) and without (45%) H pylori. In conclusion, the lack of association of acute perforated duodenal ulcer and H pylori infection suggests that perforated duodenal ulcer has a different pathogenesis from chronic duodenal ulcer disease, and that the first should not be regarded simply as a complication of the second.<\/jats:p>","DOI":"10.1136\/gut.34.10.1344","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"1344-1347","source":"Crossref","is-referenced-by-count":108,"title":["Acute perforated duodenal ulcer is not associated with Helicobacter pylori infection."],"prefix":"10.1136","volume":"34","author":[{"given":"D H","family":"Reinbach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Cruickshank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K E","family":"McColl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1993,10,1]]},"reference":[{"key":"ref_1","first-page":"1109","article-title":"Campylobacter pylori and recurrence of duodenal ulcers","volume":"ii:","author":"Coghlan, J.G.; Gilligan, D.; Humphries, H.; McKenna, D.; Dooley, C.; Sweeney, E.","year":"1987","unstructured":"Coghlan JG, Gilligan D, Humphries H, McKenna D, Dooley C, Sweeney E, et al. Campylobacter pylori and recurrence of duodenal ulcers. A 12 month follow-up study. Lancet 1987; ii: 1109-11."},{"key":"ref_2","first-page":"1437","article-title":"Prospective double-blind trial of duodenal ulcer relapse after eradication of campylobacter pylori","volume":"ii:","author":"Marshall, B.J.; Goodwin, C.S.; Warren, JR, Murray; R, Blincow; ED, Blackbourn; S.J.","year":"1988","unstructured":"Marshall BJ, Goodwin CS, Warren JR, Murray R, Blincow ED, Blackbourn SJ, et al. Prospective double-blind trial of duodenal ulcer relapse after eradication of campylobacter pylori. Lancet 1988; ii: 1437-41.","journal-title":"Lancet"},{"key":"ref_3","first-page":"233","article-title":"Cure of duodenal ulcer associated with eradication of Helicobacter pylori","volume":"335","author":"Rauws, E.A.J.; Tytgat, G.N.J.","year":"1990","unstructured":"Rauws EAJ, Tytgat GNJ. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet 1990; 335: 233-5.","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1136\/gut.34.8.1060","article-title":"Eradicating Helicobacter pylori infection lowers gastrinmediated acid secretion by two-thirds in duodenal ulcer patients","volume":"34","author":"El-Omar, E.; Penman, I.; Dorrian, C.A.; Ardill, J.E.S.; McColl, K.E.L.","year":"1993","unstructured":"El-Omar E, Penman I, Dorrian CA, Ardill JES, McColl KEL. Eradicating Helicobacter pylori infection lowers gastrinmediated acid secretion by two-thirds in duodenal ulcer patients. Gut 1993; 34: 1060-5.","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1136\/gut.32.9.973","article-title":"Detection of Helicobacter pylori infection of the gastric mucosa by measurement of gastric aspirate ammonium and urea concentrations","volume":"32","author":"Neithercut, W.D.; Milne, A.; Chittajallu, R.S.; Nujumi, A.M.E.I.; McColl, K.E.L.","year":"1991","unstructured":"Neithercut WD, Milne A, Chittajallu RS, Nujumi AMEI, McColl KEL. Detection of Helicobacter pylori infection of the gastric mucosa by measurement of gastric aspirate ammonium and urea concentrations. Gut 1991; 32: 973-6.","journal-title":"Gut"},{"key":"ref_6","first-page":"140","article-title":"Helicobacter pylori, duodenitis and duodenal ulceration in Helicobacter pylori","author":"Wyatt, J.I.","year":"1992","unstructured":"Wyatt JI. Helicobacter pylori, duodenitis and duodenal ulceration in Helicobacter pylori and gastroduodenal disease. Eds Rathbone BJ, Heatley RV. 2nd edition. London: Blackwell Scientific, 1992; 140-50.","edition":"2nd edition"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1136\/gut.32.12.1461","article-title":"Simplified single sample \"carbon urea breath test for Helicobacter pylori: Comparison with histology, culture, and ELISA serology","volume":"32","author":"Logan, R.P.H.; Polson, R.J.; Misiewicz, J.J.; Rao, G.; Karim, N.Q.; Newell, D.","year":"1991","unstructured":"Logan RPH, Polson RJ, Misiewicz JJ, Rao G, Karim NQ, Newell D, et al. Simplified single sample \"carbon urea breath test for Helicobacter pylori: Comparison with histology, culture, and ELISA serology. Gut 1991; 32: 1461-4.","journal-title":"Gut"},{"key":"ref_8","first-page":"1257","article-title":"Performance of a commercially available serological test for Helicobacter pylori and its relation to age","volume":"32","author":"Mendall, M.A.; Goggin, P.; Bellhouse, A.; Molineaux, N.J.; Marrero, J.; Tucker, R.J.","year":"1991","unstructured":"Mendall MA, Goggin P, Bellhouse A, Molineaux NJ, Marrero J, Tucker RJ, et al. Performance of a commercially available serological test for Helicobacter pylori and its relation to age. Gut 1991; 32: A1257.","journal-title":"Gut"},{"issue":"1","key":"ref_9","first-page":"71","article-title":"Gastric perforation: An acute disease unrelated to H pylori?","volume":"78","author":"Debongnie, J.C.; Legros, G.","year":"1990","unstructured":"Debongnie JC, Legros G. Gastric perforation: An acute disease unrelated to H pylori? Rev Esp Enferm Dig 1990; 78 (suppl 1): 71-2.","journal-title":"Rev Esp Enferm Dig"},{"key":"ref_10","first-page":"85","article-title":"Differing prevalence of Helicobacter in bleeding and non-bleeding ulcers","volume":"102","author":"Hosking, S.W.; Yung, M.Y.; Chung, S.C.; Li, A.K.C.","year":"1992","unstructured":"Hosking SW, Yung MY, Chung SC, Li AKC. Differing prevalence of Helicobacter in bleeding and non-bleeding ulcers. Gastroenterology 1992; 102: A85.","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/gut.28.5.527","article-title":"Non-steroidal anti-inflammatory drugs and life threatening complications of peptic ulceration","volume":"28","author":"Armstrong, C.P.; Blower, A.L.","year":"1987","unstructured":"Armstrong CP, Blower AL. Non-steroidal anti-inflammatory drugs and life threatening complications of peptic ulceration. Gut 1987; 28: 527-32.","journal-title":"Gut"},{"key":"ref_12","first-page":"693","article-title":"All perforated ulcers are not alike","volume":"209","author":"Horowitz, J.; Kukora, J.S.; Ritchie, W.P.","year":"1989","unstructured":"Horowitz J, Kukora JS, Ritchie WP. All perforated ulcers are not alike. Ann Surg 1989; 209: 693-7."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1136\/gut.26.4.359","article-title":"Non-steroidal anti-inflammnatory drugs and peptic ulcer perforation","volume":"26","author":"DStJ, Collier; JA, Pain","year":"1985","unstructured":"Collier DStJ, Pain JA. Non-steroidal anti-inflammnatory drugs and peptic ulcer perforation. Gut 1985; 26: 359-63.","journal-title":"Gut"},{"key":"ref_14","first-page":"871","article-title":"Influence of cigarette smoking on healing and relapse","volume-title":"duodenal ulcer disease. Gastroenterology 1983; 85","author":"Korman, M.G.; Hansky, J.; Eaves, E.R.; Schmidt, G.T.","unstructured":"Korman MG, Hansky J, Eaves ER, Schmidt GT. Influence of cigarette smoking on healing and relapse in duodenal ulcer disease. Gastroenterology 1983; 85: 871-4."},{"key":"ref_15","first-page":"1154","article-title":"Helicobacter pylori-negative duodenal ulcer","volume":"86","author":"Borody, T.J.; George, L.L.; Brandl, S.; Andrews, P.; Ostapowicz, N.; Hyland, L.","year":"1991","unstructured":"Borody TJ, George LL, Brandl S, Andrews P, Ostapowicz N, Hyland L, et al. Helicobacter pylori-negative duodenal ulcer. AmJIGastroenterology 1991; 86: 1154-7.","journal-title":"AmJIGastroenterology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/0002-9343(91)90067-8","article-title":"Helicobacter pylori-negative duodenal ulcer","volume":"91","author":"Nensey, Y.M.; Schubert, T.T.; Bologna, S.D.; Ma, C.K.","year":"1991","unstructured":"Nensey YM, Schubert TT, Bologna SD, Ma CK. Helicobacter pylori-negative duodenal ulcer. Amj Med 1991; 91: 15-8.","journal-title":"Amj Med"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1136\/gut.34.6.762","article-title":"A study of the pathogenesis of Helicobacter pylori-negative chronic duodenal ulcer disease","volume":"34","author":"McColl, K.E.L.; El-Nujumi, A.M.; Chittajallu, R.S.; Dahill, S.W.; Dorrian, C.A.; Graham, H.","year":"1993","unstructured":"McColl KEL, El-Nujumi AM, Chittajallu RS, Dahill SW, Dorrian CA, Graham H, et al. 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