ReviewCureus2026
A Comparative Analysis of Generalized Peritonitis Secondary to Upper Gastrointestinal Perforation: Surgical Approaches, Antibiotic Management, and Patient Outcomes.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Generalized peritonitis due to gastric or peptic ulcer perforation (PULP) carries substantial morbidity and mortality. This study is a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic review, conducted using PubMed, MEDLINE, Embase, Scopus, and Cochrane, from January 2020 to August 2025. Adults with generalized peritonitis from gastric/PULP reporting surgery, antibiotics, and outcomes were included. Two independent reviewers conducted the screening and data extraction, assessing the risk of bias (RoB) using the Newcastle-Ottawa Scale for observational studies and RoB2 for randomized controlled trials. A narrative synthesis was conducted due to clinical/methodological heterogeneity. Twenty-five studies met the criteria. The contemporary series showed variable 30-day or in-hospital mortality. The highest rates were observed when the time to surgery exceeded 12-24 hours, in cases of shock, among older patients, and for those with an American Society of Anesthesiologists classification of ≥III. Laparoscopic repair, when feasible, was consistently associated with shorter length of stay and fewer wound infections than open repair, with similar mortality; conversion was more likely with higher PULP scores. Omental patch repair predominated and showed lower complications than gastric resection, the latter reserved for large, malignant, or recurrent ulcers. Empiric broad-spectrum antibiotics were universally initiated, with variable stewardship/deescalation. Outcomes hinge on early resuscitation, rapid source control, and structured sepsis care. Laparoscopy reduces morbidity when expertise/resources are available; globally, the omental patch remains first-line. Standardized antibiotic pathways and risk-based triage may reduce variation, but timely access and critical care capacity are decisive.
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Registered trials
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