Non operative management of perforated peptic ulcer an algorithm approach.

Ulcer disease remains the most common cause of gastroduodenal perforation, with an incidence between 2% and 10% in patients with ulcers. With the advent of proton pump inhibitors(PPI) the surgery for perforated peptic ulcer has changed from perforation closure with definitive acid reduction surgeries to simple omental patch. The trend of minimal is better holds good. With advances in laparoscopic surgery and its application in emergency abdominal conditions it has been shown feasible for management of perforated peptic ulcer. Though there have been various studies showing successful nonoperative management of perforated peptic ulcer, Conservative treatment has not gained widespread acceptance as an alternative approach to surgery. The reason being lack of uniform selection criteria and management guidelines for conservative management. This review article aims at introducing an algorithm approach towards successful non operative management of perforated peptic ulcer.