SURGICAL TREATMENT OF PERFORATED PEPTIC ULCER IN PATIENTS WITH SYSTEMIC ARTERIAL HYPERTENSION: MULTIDISCIPLINARY APPROACH BETWEEN GASTROENTEROLOGY AND CLINIC MEDICINE

Abstract

Perforated peptic ulcer is a critical condition that requires immediate surgical intervention, presenting with high morbidity and mortality. Systemic arterial hypertension, a prevalent condition in the population, can complicate the management of these patients, increasing the risk of perioperative complications and impacting recovery. Women, in particular, may face additional challenges due to hormonal and metabolic factors. A multidisciplinary approach between gastroenterology and clinical medicine becomes essential to optimize treatment, ensuring strict control of blood pressure and adequate management of associated conditions, promoting better clinical outcomes. Objective: To analyze the surgical treatment of perforated peptic ulcers in patients with systemic arterial hypertension, emphasizing the importance of a multidisciplinary approach. Methodology: The methodology was structured according to the PRISMA checklist. The databases used included PubMed, Scielo and Web of Science, with the descriptors Duodenal perforation, Helicobacter pylori, Medical treatment, Proton pump inhibitors and Antibiotics. Inclusion criteria were: studies discussing surgical treatment in patients with perforated peptic ulcers and hypertension, publications from the last 10 years, and studies including data on women. Articles that did not focus on surgical management, literature reviews, and studies with small sample sizes were excluded. Results: The results indicated that surgical treatment, such as suturing perforations or resections, should be performed with caution in hypertensive patients. The analysis revealed that strict blood pressure control and management of comorbidities contributed to the reduction of postoperative complications. In addition, collaboration between gastroenterologists and clinicians was essential to optimize the management of these patients. Conclusion: Surgical treatment of perforated peptic ulcers in patients with systemic arterial hypertension requires a careful multidisciplinary approach. The review highlighted the importance of adequate planning and collaborative interventions, especially for women, aiming to improve clinical outcomes and postoperative recovery.