Early Detection and Intervention for Acute perforated Peptic Ulcer after Elective Spine Surgeries: A Review of 13 Cases from 24,026 Patients

Abstract

Background:To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgeryMethods:Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed.Results:Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressive. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer. Conclusion:Spine surgeons should be highly suspicious of a perforated peptic ulcer if a patient with abnormal high serum amylase level, a history of peptic ulcer and nonsteroidal anti-inflammatory druguse experiences, progressive pain in the epigastrium accompanied by abdominal rigidity and absent bowel sounds. Early diagnosis and emergency surgical intervention promote better outcomes.