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Results for “PEPTIC ULCER PERFORATION”

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At least 775 records · Page 43Linked to original sources
PubMed1997

Smoking and ulcer perforation.

BACKGROUND: The use of ulcerogenic drugs is the only well documented risk factor for peptic ulcer perforation, but accounts for only a quarter of the events. Smoking is a well known risk factor for uncomplicated ulcer disease, and patients with ulcer bleeding have increased death rates from smoking related disorders. AIM: To assess the role of smoking in ulcer perforation. SUBJECTS: A total of 168 consecutive patients with gastroduodenal ulcer perforation and 4469 control subjects from a population based health survey. METHODS: The association between ulcer perforation and smoking habits was analysed by logistic regression while adjusting for age and sex. RESULTS: Current smoking increased the risk for ulcer perforation 10-fold in the age group 15-74 years (OR 9.7, 95% CI 5.9 to 15.8) and there was a highly significant dose-response relationship (p < 0.001). The results were similar in men (OR 9.3, 95% CI 4.9 to 17) and women (OR 11.6, 95% CI 5.3 to 25), and for gastric (OR 10.5, 95% CI 4.5 to 25) and duodenal (OR 8.6, 95% CI 4.9 to 15.4) ulcer perforation. No increase in risk was found in previous smokers (OR 0.8, 95% CI 0.2 to 2.2). CONCLUSION: Our findings suggest that smoking is a causal factor for ulcer perforation and accounts for a major part of ulcer perforations in the population aged less than 75 years.

Adolescent↗
PubMed1989

Abdominal pain: a surgical audit of 1190 emergency admissions.

In an audit of 1190 emergency admissions with abdominal pain (1166 patients) in a general surgical unit, the diagnosis was non-specific abdominal pain (NSAP) in 415 (35 per cent), acute appendicitis in 200 (17 per cent) and intestinal obstruction in 176 (15 per cent). The largest number of admissions occurred in the age groups 10-29 years (31 per cent) and 60-79 years (29 per cent). Surgical operations were performed in 551 patients (47 per cent) and there was a 16 per cent incidence of unnecessary appendicectomy (22 per cent in the age group 20-29 years). Fifty-one deaths resulted in a 30-day hospital mortality rate of 4.4 per cent and a perioperative mortality rate of 8 per cent. The mortality rate increased significantly in patients aged greater than or equal to 60 years, and patients aged 80-89 years had a perioperative mortality rate of 20 per cent. The causes of perioperative death included laparotomy for inoperable disease (28 per cent), ruptured abdominal aortic aneurysm (23 per cent), perforated peptic ulcer (16 per cent) and colonic resections (14 per cent). The perioperative mortality rates for ruptured aneurysm and perforated ulcer were 71 and 23 per cent respectively. The duration of inpatient stay increased significantly with the age of the patients, including those with NSAP. The results of the study indicate a need to review the methods of management of ruptured aortic aneurysm and perforated peptic ulcer, the methods of diagnosis of appendicitis, particularly in young females, and the factors that determine the duration of stay of patients suffering from NSAP.

Abdominal Pain↗
PubMed2003

Predictors of pre- and postoperative anxiety in emergency surgery patients.

OBJECTIVE: Emergency surgery is a highly stressful life event. Patients experience distressing anxiety both before and after surgery and this anxiety affects their recovery process. The aim of the present study is to examine variables related to pre- and postoperative anxiety in emergency surgery patients. METHODS: The sample consisted of 146 emergency surgery patients who had abdominal surgery in an emergency surgery clinic. The research instruments were administered before and after the surgery. State Anxiety Inventory (STAI-A State), Anxiety Specific to Surgery Questionnaire (ASSQ), a scale tapping fears and worries specific to surgery developed for the present study, Ways of Coping Inventory (WCI), and the Multidimensional Scale of Perceived Social Support (MSPSS) were administered. DATA ANALYSIS: Data were analyzed by using the appropriate programs of the Statistical Package for the Social Sciences (SPSS). RESULTS: There was a significant drop in anxiety from the pre- to the postoperative period. Female patients had higher preoperation anxiety than males. Females and males did not differ in anxiety at the postoperation period. Being female, waiting for primary suture for peptic ulcer perforation operation, and helplessness and self-blaming coping appeared as significant predictors of anxiety specific to surgery. Being female and awaiting for primary suture for peptic ulcer perforation were significant predictors of preoperative state anxiety. Finally, years of education were negatively and use of active coping was positively related to postoperative state anxiety. CONCLUSION: Patient sociodemographic and psychological characteristics and type of surgery need to be considered for identifying patients at risk of experiencing anxiety both before and after surgery and psychological support and clinical management needs to be tailored to the needs of the patients to alleviate their anxiety.

Adaptation, Psychological↗
PubMed1992

CT in upper gastrointestinal tract perforations secondary to peptic ulcer disease.

Computed tomographic (CT) scans of 11 patients with perforations of the stomach or duodenum were reviewed to determine the variety and relative conspicuity of findings. Five patients had de novo presentation due to perforation of peptic ulcers, two had perforations at ulcer repair sites, and the remaining four patients had ulcer perforations following unrelated surgery. CT allowed recognition of at least one component of bowel perforation, such as extra-gastrointestinal gas and/or contrast, in most patients. In only three patients (27%), however, could these findings be specifically related to a perforation of the stomach or duodenum from the CT scans alone.

Adult↗
PubMed1998

Combined laparoscopic-endoscopic method using an omental plug for therapy of gastroduodenal ulcer perforation.

BACKGROUND: Laparoscopic techniques have been proposed as an alternative to open surgery for therapy of peptic ulcer perforation. They provide better postoperative comfort and absence of parietal complications, but leakage occurs in 5% of cases. We describe a new method combining laparoscopy and endoluminal endoscopy, designed to ensure complete closure of the perforation. METHODS: Six patients with anterior ulcer perforations (4 duodenal, 2 gastric) underwent a concomitant laparoscopy and endoluminal endoscopy with closure of the orifice by an omental plug attracted into the digestive tract. RESULTS: All perforations were sealed. The mean operating time was 72 minutes. The mean hospital stay was 5.5 days. There was no morbidity and no mortality. At the 30-day evaluation all ulcers but one (due to Helicobacter pylori persistence) were healed. CONCLUSIONS: This method is safe and effective. Its advantages compared with open surgery or laparoscopic patching as well as its cost-effectiveness should be studied in prospective randomized trials.

Adult↗
PubMed1999

[Video laparoscopy in abdominal emergencies].

BACKGROUND: Personal experience about the use of video laparoscopy (VL) in abdominal emergencies is reported. METHODS DESIGN: retrospective evaluation of patients observed in the last years. SETTING: General Surgery I. Policlinico, University of Palermo. SUBJECTS: 61 VL have been performed: 30 acute appendicitis, 21 acute cholecystitis, 4 perforated peptic ulcer, 1 haemoperitoneum by haemorrhaged luteal corpus, 2 pelvic inflammatory disease (PID), 1 terminal ileitis, 1 choledochal perforation after ERCP and 1 bleeding after CVL. INTERVENTIONS: the following interventions have been performed: 22 VL appendectomy, 8 VL-assisted appendectomy, 21 VL cholecystectomy, 1 VL duodenal suture, 3 minilaparotomic duodenal suture, 2 prophylactic VL-assisted appendectomy, in 1 patient with terminal ileitis and in 1 PID, 1 VL partial ovarian resection. In the case with choledochal perforation during ERCP a traditional cholecystectomy was performed with an outer biliary drainage. In the patient with bleeding after CVL the spontaneous haemostasis seen during VL was confirmed by laparotomy performed to exclude baro-haemostasis and to prevent from legal motivation. The procedure was only diagnostic in 1 patient with PID. MAIN OUTCOME MEASURES: the diagnostic and therapeutic value, versus traditional surgery have been valued. RESULTS: VL is useful both for a correct diagnosis and to lead a laparotomy if necessary, allowing an adequate peritoneal exploration and toilet without large incisions; the operation is therefore, in any case, less invasive. CONCLUSIONS: In our experience the usefulness of VL is clear in the suspect of acute appendicitis, acute cholecystitis, perforated peptic ulcer, haemoperitoneum and when diagnosis is not sure and in all other situations in which correct preoperative diagnosis is impossible. So this procedure is useful to make easy a correct diagnosis and to surgical treatment.

Abdomen, Acute↗