High Altitude Area- A Risk Factor For Gastric Perforation?

This is an original case series on soldiers evacuated from HAA(High Altitude Area) over last one year(Sept 2017- Aug 2018) , of which 100% cases were found to have gastric antrum perforation. This is a deviation from the usual trend that is being noted in Indian subcontinent where duodenal perforations are commonest.

Study Overview

• Status: Completed
• Conditions: Gastric Perforation

Detailed Description

INTRODUCTION : This is an original case series on soldiers evacuated from HAA(High Altitude Area) over last one year(Sept 2017- Aug 2018) , of which 100% cases were found to have gastric antrum perforation. This is a deviation from the usual trend that is being noted in Indian subcontinent where duodenal perforations are commonest.

DISCUSSION : High altitude associated dyspepsia is a common phenomenon and some studies done in high altitude population have recorded high incidence of antral gastritis and mucosal atrophy on histo-pathological evaluation. This is also supported by high incidence of H.pylori infection. The presence of atrophic gastric mucosa associated with antral gastritis, when exposed to hypobaric hypoxemic conditions faced by soldiers posted to heights above 15000ft , may leads to increased intra-luminal pressure and ischemia which probably predisposes individuals for gastric antrum perforations.

CONCLUSION : This is a relatively untouched topic as we have not found studies on high altitude related gastric perforations and probably this is the first case series of its kind. The acknowledgement of this phenomenon may pave way for further studies for defining the role of high altitude in gastric perforations.

• Study Type: Observational
• Enrollment (Actual): 5

Contacts and Locations

Study Locations

• India
  • Jammu AND Kashmir
    • Leh, Jammu AND Kashmir, India, 194401
      • 403 Military Field Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

• Sampling Method: Non-Probability Sample

Study Population

Young soldiers located in High Altitude Area

Description

Inclusion Criteria:

• Individuals located in High Altitude Area (>10,000ft).
• presented as perforation peritonitis.
• intra-operatively found to be perforated peptic ulcers.

Exclusion Criteria:

• Not located in High Altitude Area.
• intra-operatively perfoarations sites other then stomach and duodenum.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of site of perforated peptic ulcers by intra-operative observation in cases evacuated from High Altitude Area.	Study aims at recording the site of perforated peptic ulcers in cases being evacuated in individuals posted at High Altitude Area.	1 year

Collaborators and Investigators

• Sponsor: ADITYA PAWAR
• Investigators: Principal Investigator: Aditya Pawar, MS, 403 Military Field Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 15, 2018
• Primary Completion (Actual): September 30, 2018
• Study Completion (Actual): October 10, 2018

Study Registration Dates

• First Submitted: October 26, 2018
• First Submitted That Met QC Criteria: October 27, 2018
• First Posted (Actual): October 30, 2018

Study Record Updates

• Last Update Posted (Actual): October 31, 2018
• Last Update Submitted That Met QC Criteria: October 30, 2018
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: High Altitude; Gastric Antrum Perforation; Mucosal Atrophy; Intra Luminal Pressure
• Other Study ID Numbers: 403HAAPPU

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No