Diagnosis of Perforated Gastric Ulcers by Ultrasound

Wallstabe, L; Veitt, R; Körner, Th.

doi:10.1055/s-2002-35261

Cited by 9 publications

(4 citation statements)

References 17 publications

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“…In our study 3 patients who presented in the acute period had leukocytosis, but case 2 who presented at day 10 had leukopenia. Even though extra luminal free air is the most common and consistent finding of gastroduodenal perforation, it may be absent at the onset of symptoms as was shown in 30%-50% of patients (11). Perforation sites can be often categorized by the CT findings, for instance: ulceration or a focal defect of the gastroduodenal wall, air bubbles in contact with the stomach or the duodenum, abrupt wall thickening associated with adjacent "dirty fat" density and local fluid between the duodenum and the pancreatic head (12).…”

Section: Discussionmentioning

confidence: 94%

A Rare Cause of Acute Abdominal Pain in Childhood: Peptic Ulcer Perforation

Yurtseven¹,

Küçük²,

Dökümcü³

et al. 2018

jpr

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A 16 years-old boy presented to the emergency department with a history of intermittent pre-prandial epigastric pain over a 3-month period. Cholelithiasis was detected in his prior examination at another healthcare facility. Upon admission, Four children with a mean age of 12 years were referred to our emergency department with a history of abdominal pain. Examination revealed tenderness in the lower abdomen, in particular the left iliac fossa. The youngest child, who was 3 years old, also presented with shock. Abdominal X-rays revealed free air under both hemidiaphragms. Subsequent surgery was administered as the primary treatment of three patients and a partial resection was performed in the remaining one. The youngest child died and the others were discharged. These cases emphasize that although uncommon, alternate diagnoses must be kept in mind in children presenting with lower abdominal pain.

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Section: Discussionmentioning

confidence: 94%

A Rare Cause of Acute Abdominal Pain in Childhood: Peptic Ulcer Perforation

Yurtseven¹,

Küçük²,

Dökümcü³

et al. 2018

jpr

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“…[17] However, several case series showed that x-ray may be negative for free air, especially in elderly patients. [21] We diagnosed the patients with abdominal pain by chest X-ray.…”

Section: Discussionmentioning

confidence: 99%

The effect of platelet–albumin ratio on mortality and morbidity in peptic ulcer perforation

Bilge¹,

Başol²

2022

Medicine

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Background: The aim of our study was to investigate the prognostic role of platelet/albumin ratio in patients treated under emergency conditions for peptic ulcer perforation (PUP).Methods: A retrospective study involving emergency patients who were operated for PUP was carried out. The patients were divided into 2 groups: PUP patients who died after surgical treatment (PUP-M) and PUP patients who survived after surgical treatment (PUP-S). The laboratory values of the patients were compared statistically. A P value of <.05 was considered statistically significant.Results: This cohort study consisted of 171 patients treated between June 2013 and December 2019. The mean age of the patients was 46.3 ± 20.5 years; and 33 (19.3%) patients were women. The age (P ≤ .001), platelet/lymphocyte ratio (P = .02), lactic dehydrogenase to albumin ratio (P ≤ .001), and platelet/albumin ratio (PAR; P ≤ .001) values were high and lymphocyte count was low (P = .006) in the PUP-M group. A positive correlation was determined between length of stay in hospital and age (P ≤ .001), lactic dehydrogenase/albumin ratio (P ≤ .001), platelet count (P = .044), and PAR (P ≤ .001). A substantial negative correlation was determined between length of stay in hospital and albumin count (P ≤ .001).Conclusions: We determined a high preoperative PAR level in PUP patients who had undergone surgery as a negative prognostic parameter. PAR is a candidate biomarker for clinical practice.Abbreviations: CRP = C-reactive protein, LDH = lactic dehydrogenase, MPV = middle platelet volume, PAR = platelets to albumin ratio, PUP-M = patients who died after surgical treatment, PUP-S = patients who survived after surgical treatment, WBC = white blood cell.

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“…A previous study used fast ultrasound or computerized tomography scan to confirm diagnosis and early treatment of PUP as plain abdominal X-ray does not always prove perforation, particularly in the early stages 14,15. Several case series have shown that in 30%–50% of patients, the X-ray may be negative for free air, particularly in the elderly 15. Unfortunately, ultrasound and computed tomography scans are limited in a developing country such as Thailand.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic indicators for peptic ulcer perforation at a tertiary care hospital in Thailand

Suriya¹,

Kasatpibal²,

Kunaviktikul³

et al. 2011

CEG

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IntroductionLimited data currently exists regarding the diagnostic indicators of peptic ulcer perforation for early detection among patients in Thailand. Delayed diagnosis and treatment for an ulcer can be life-threatening, resulting in shock or death.ObjectiveTo determine the diagnostic indicators of peptic ulcer perforation.Material and methodsA cohort study was conducted in a tertiary care hospital in Thailand from 2005 to 2009. Peptic ulcer patients aged 15 years and over admitted to the surgical department were included. The diagnostic indicators used criteria of the patients’ final diagnoses and operations, coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, which included patient profiles, gender, age, coexisting illnesses, personal habits, signs and symptoms, laboratory investigations, radiological finding, and treatment role. Exponential risk regression analyses to obtain relative risk (RR) estimates for diagnostic indicators were analyzed using Stata® statistical software package, version 11 (StataCorp LP, College Station, TX).ResultsThe study included 1290 patients. Of these, 57% reported perforated peptic ulcer. Multivariate analysis showed five diagnostic indicators: signs and symptoms including intense abdominal pain (RR = 1.53, 95% confidence interval [CI] 1.14–2.06), tenderness (RR = 1.94, 95% CI 1.17–3.21), and guarding (RR = 1.52, 95% CI 1.05–2.20); X-ray with free air (RR = 2.80, 95% CI 2.08–3.77); and referral from other hospitals (RR = 1.37, 95% CI 1.03–1.82).ConclusionFive diagnostic indicators for peptic ulcer perforation monitoring were suggested from this study. Improving diagnostic indicators for medical care may improve the outcome of patients that have perforated peptic ulcer.

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Diagnosis of Perforated Gastric Ulcers by Ultrasound

Cited by 9 publications

References 17 publications

A Rare Cause of Acute Abdominal Pain in Childhood: Peptic Ulcer Perforation

A Rare Cause of Acute Abdominal Pain in Childhood: Peptic Ulcer Perforation

The effect of platelet–albumin ratio on mortality and morbidity in peptic ulcer perforation

Diagnostic indicators for peptic ulcer perforation at a tertiary care hospital in Thailand

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