Final answer:
Emergency surgery and antibiotic therapy are critical in managing a patient with a ruptured PUD leading to peritonitis and sepsis. Immediate intervention is needed to repair the perforation and address the infection to improve survival chances.
Step-by-step explanation:
The management of a patient with a ruptured peptic ulcer disease (PUD) that has led to chemical peritonitis and sepsis requires immediate and aggressive medical intervention. The presence of fresh gastric contents in the peritoneal cavity indicates a breach in the alimentary canal, which has allowed gastric juices to spill and cause inflammation. Emergency surgery is necessary to repair the perforation and cleanse the peritoneal cavity of contaminants. Additionally, intensive antibiotic therapy is crucial to combat the bacterial infection that is likely present, given the deterioration of the patient's condition and the onset of hypotension during surgery.
In the past, the mortality rate from peritonitis was very high, but today it has been greatly improved thanks to advances in surgical techniques, anesthesia safety, critical care expertise, and the development of effective antibiotics. The current mortality rate still ranges from 30 to 40 percent, which emphasizes the seriousness of this condition and the need for immediate and competent care. Preventing complications like perforation with proper management of ulcers is key—they can be treated with antibiotics to kill H. pylori and medications to decrease stomach acid.