History of Perforated Duodenal and Gastric Ulcers

Lau, Wan Yee; Leow, C. K.

doi:10.1007/s002689900323

Cited by 54 publications

(42 citation statements)

References 89 publications

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“…Studies like that of Forbes et al [18]with the corroboration of René et al [19], where they carried out a treatment of eradication using acid blockers plus antibiotics, discovered that recurrent ulcers were much more frequent in H. pylori -positive patients, while they were less frequent in the negative ones. Likewise, recent studies [20, 21, 22, 23]have shown the presence of H. pylori in perforated duodenal ulcer, showing the important factor that it plays in the perforation.…”

Section: Discussionmentioning

confidence: 85%

Simple Closure or Vagotomy and Pyloroplasty for the Treatment of a Perforated Duodenal Ulcer: Comparison of Results

Peña¹,

Marquez²,

Fakih³

et al. 2000

Dig Surg

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Background/Aims: Treatment of the perforated duodenal ulcer continues to be a controversial subject. The purpose of our study was to compare the results of simple closure of perforated duodenal ulcer versus treatment by truncal vagotomy and pyloroplasty. Methods: We present a prospective and randomized study of 207 patients who underwent surgical treatment due to perforated duodenal ulcer. In 117 patients the surgical treatment was simple closure and postsurgery medical treatment with proton pump inhibitors for 1 month, and in 90 patients vagotomy and pyloroplasty with no additional medical treatment. Results: We applied the Visick scale in order to compare postsurgery results. The postoperative morbidity and mortality rates were the same with both techniques. Statistically, in both cases, no significant differences were found in postsurgery symptomatology. The different rates of recurrent ulcers and the reinterventions due to recurrent ulcers presented no significant statistical values. Conclusion: We conclude that simple closure remains the selected treatment in the majority of patients who present with a perforated duodenal ulcer. The operation is a simple and safe procedure.

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Section: Discussionmentioning

confidence: 85%

Simple Closure or Vagotomy and Pyloroplasty for the Treatment of a Perforated Duodenal Ulcer: Comparison of Results

Peña¹,

Marquez²,

Fakih³

et al. 2000

Dig Surg

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“…He said, " every doctor who is faced with a perforated duodenal ulcer of the stomach or the intestine must consider opening the abdomen, sewing up the hole and averting a possible inflammation by a careful cleansing of the abdominal cavity" [6]. In 1843, Edward Crisp was the first to report 50 cases of PPUs and he concluded that, "the symptoms are so typical, I hardly believe that it is possible that anyone can fail in making the diagnosis" [7]. Several scoring systems like the Boye scoring system and the Mannheim Peritonitis Index (MPI) are used to risk stratify the patients and to predict the outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Perforation-Operation time Interval; an Important Mortality Indicator in Peptic Ulcer Perforation

Surapaneni¹,

Vb²

2013

JCDR

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Objective: To find out the significance of the PerforationOperation Interval (POI) with respect to an early prognosis, in patients with peritonitis which is caused by peptic ulcer perforation.Study Design: Case series. Materials and Method:This study included 150 patients with generalized peritonitis, who were diagnosed to have Perforated Peptic Ulcers (PPUs). The diagnosis of the PPUs was established on the basis of the history , the clinical examination and the radiological findings. The perforation-operation interval was calculated from the time of onset of the symptoms like severe abdominal pain or vomiting till the time the patient was operated.Result: Out of the 150 patients 134 were males and 16 were females, with a male : female ratio of 9:1. Their ages ranged between 25-70 years. Out of the 150 patients, 65 patients (43.3%) presented within 24 hours of the onset of severe abdominal pain (Group A), 27 patients (18%) presented between 24-48 hours of the onset of severe abdominal pain (Group B) and 58 patients (38.6%) presented after 48 hours. There was no mortality in Group A and the morbidity was more in Group B and Group C. There were 15 deaths in Group C. Conclusion:The problem of peptic ulcer perforation with its complication, can be decreased by decreasing the perforation -operation time interval, which as per our study, appeared to be the single most important mortality and morbidity indicator in peptic ulcer perforation.SuShama Surapaneni, rajKumar S, Vijaya bhaSKar reddy a.

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“…As restricting the surgery to suturing of the ulcer involved a high risk of relapse, in the past definitive surgery, which would decrease the hydrochloric acid secretion, was the aim [8,17]. Easy and quick to perform, simple ulcer suturing was advised at that time as a treatment of choice in perforated duodenal ulcer occurring in elderly patients due to increased operational risk as a result of comorbidity and in patients in bad general condition [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…In the same year, Mouret et al published the initial results of laparoscopic perforation treatment by suturing a 'patch' of greater omentum above the perforation and sealing the omentum with fibrinous glue [25][26][27]. In the following years various laparoscopic techniques were developed for perforated ulcer treatment: the use of sutures with one or three sutures, gelatine sponge and fibrinous glue, fixing the greater omentum around the perforation with a stapler, blocking the perforation with a round ligament of the liver using a gastroscope, and blocking the perforation with part of the greater omentum, also using a gastroscope [7,17,26,[28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Results of surgical treatment of perforated peptic ulcer

Tarnowski¹,

Bielecki²,

Kamiński³

et al. 2011

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Introduction: Effective treatment with H 2 -blockers and proton pump inhibitors almost removed the necessity of elective surgical treatment of refractory peptic ulcer disease. Life-threatening complications of peptic ulcer still occur and patients with perforated peptic ulcer almost always need surgical treatment. Material and methods: Seventy-five consecutive patients aged 16-91 years (31 women and 44 men) operated on because of perforated peptic ulcer in our department between 1 January 2001 and 31 December 2009 were studied retrospectively. Results: The mean age was 51.5 ±20.5 years. Of the 75 patients, 34 (45.3%) had co-morbid disease, 14 (18.6%) presented with a delay of more than 24 h, 16 (21.3%) were older than 70 years and 25 (33.3%) were assessed as ASA grade 3 or more. Postoperative complications occurred in 19 patients (25.9%). Cardio-pulmonary failure (5 patients) and wound infection (4 patients) were the most common. The mean hospital stay of recovered patients was 7.7 days (3-38). Eleven (14.6%) patients died. Age above 70 years, presence of comorbid illness, presence of abdominal postoperative complications, American Society of Anesthesiologists (ASA) grade 3 or more, presence of shock on admission and gastric localisation of ulcer were identified as factors increasing risk of mortality. Conclusions: The incidence of perforated peptic ulcer among elderly patients, females in particular, is increasing. The number of patients with perforated peptic ulcer as the first symptom of peptic ulcer is increasing. Perforated peptic ulcer still involves high postoperative mortality.

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History of Perforated Duodenal and Gastric Ulcers

Cited by 54 publications

References 89 publications

Simple Closure or Vagotomy and Pyloroplasty for the Treatment of a Perforated Duodenal Ulcer: Comparison of Results

Simple Closure or Vagotomy and Pyloroplasty for the Treatment of a Perforated Duodenal Ulcer: Comparison of Results

The Perforation-Operation time Interval; an Important Mortality Indicator in Peptic Ulcer Perforation

Results of surgical treatment of perforated peptic ulcer

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