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Results for “PEPTIC ULCER PERFORATION”

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PubMed1988

[Planned reoperation following perforation of peptic ulcer with a simple suture. A differentiated treatment concept].

Even after perforation of chronic peptic ulcer with simple closure, patients continue to be in danger for additional complications of the ulcer ailment. Postoperative conditions of patients with perforated ulcer were analysed for a period of ten years. Classical indications for re-operation were recorded from 60 per cent. A differentiated concept for treatment of ulcer perforation is presented in this paper.

Adult↗

PubMed1985

Intrapleural perforation of peptic ulcer in association with diaphragmatic hernia.

Two patients with perforation of intrathoracic peptic ulcer in association with paraoesophageal hiatus hernia are described. This unusual complication of hiatus hernia should be considered in the differential diagnosis of patients presenting with spontaneous hydropneumothorax.

Adult↗

PubMed2004

Posterior perforation of peptic ulcers: presentation and outcome of an uncommon surgical emergency.

BACKGROUND: Posterior perforation of peptic ulcer is a distinct clinical entity not commonly encountered. This report evaluates the presentation, diagnosis, management, and outcome of this acute surgical condition. METHODS: We reviewed records of 9 patients with posterior perforations who were treated at our institution from January 1990 to June 2002. RESULTS: This condition was characterized by insidious onset of upper abdominal pain and delayed presentation. Abdominal examinations were equivocal in 7 patients on admission. Pneumoperitoneum on chest roentgenogram, when present, was a crucial diagnostic indicator of intra-abdominal pathology. The diagnosis was made intraoperatively in all cases; findings were sealed perforation, localized retroperitoneal abscess, or generalized contamination of the lesser sac and peritoneal cavity. Observed adverse operative risk factors included prolonged perforation (>24 hours), pre-existing chronic medical illnesses, and preoperative hypotension. In addition, significant peritoneal contamination at celiotomy, major resection (gastrectomy), and gastric perforations were noted to be associated with a poor outcome: 4 of the 9 patients died. CONCLUSION: A high index of suspicion is important. When a retroperitoneal collection is noted at celiotomy, posterior perforation of peptic ulcer should be actively excluded.

Adult↗

PubMed2002

Morbidity and mortality of perforated peptic gastroduodenal ulcer following emergency surgery.

BACKGROUND: This study assessed the surgical concept and prognosis of perforated gastroduodenal ulcers. PATIENTS AND METHODS: Data from 102 patients who underwent emergency surgery for peptic ulcer perforation were recorded prospectively. To evaluate morbidity and mortality ulcer perforation was classified into three types: type A, solitary peripyloric ulcer located anteriorly in which laparoscopic closure by suture with omentoplasty was treatment of choice and postoperative endoscopic biopsy was mandatory; type B, perforated ulcer with large defect in which excision and suture was necessary; type C, complicated perforated ulcer with destruction of proximal duodenum and penetration into adjacent organs in which resectional surgery was indicated. RESULTS: Morbidity and mortality were significantly lower in type A (9%, 4%, respectively) than types B (22%, 20%) and C (34%, 17%). Closure of type A perforation was managed laparoscopically in all cases. Billroth II resection was performed in 75% of type C cases. Age, ASA status, and time of surgery were independent prognostic factors by multivariate analysis, with increased mortality in patients older than 65 years, ASA III and IV, and surgery after 24 h following onset of symptoms. CONCLUSIONS: Prognosis of perforated ulcer disease is highly correlated with age, comorbid conditions (ASA status), and time of surgery. The proposed classification system helps to determine patients at risk of mortality.

Adult↗

PubMed1980