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At least 991 records · Page 55Linked to original sources
PubMed2003

High incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease.

BACKGROUND: In average-risk patients, the new anti-platelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high-risk patients. AIM: To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study. METHODS: During the period from January 2000 to May 2002, 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non-aspirin-related peptic ulcer disease or a history of aspirin-related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end-point. RESULTS: After a median follow-up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel-associated gastrointestinal bleeding was significantly more common in patients with a history of gastrointestinal bleeding than in those without (22% vs. 0%; P = 0.007; odds ratio, 1.3; 95% confidence interval, 1.1-1.5). CONCLUSIONS: Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high-risk patients. A previous history of gastrointestinal bleeding appears to be a predictor of adverse gastrointestinal events.

Aged↗
PubMed1991

[Spontaneous rupture of the esophagus].

Spontaneous rupture of the esophagus is a rare emergency that requires immediate diagnosis and superior surgical treatment. Delay in diagnosis is common and is caused mostly by lack of consciousness of the disease and consequent tendency to diagnose a cases as perforated peptic ulcer, pancreatitis, acute coronary disease etc. Mortality and morbidity increase proportionally to the time between esophageal perforation and adequate treatment. In this paper the Authors present a case of Boerhaave's syndrome in a patient who underwent two surgical repairs followed by leakages of the esophageal sutures. The definitive successful treatment has been obtained with a third operation performed after complete sterilization of the mediastinum.

Adult↗
PubMed1994

Pneumoperitoneum caused by spontaneous bacterial peritonitis: a case report.

Spontaneous bacterial peritonitis (SBP) rarely presents as pneumoperitoneum. Only four such cases have been reported in the English literature. This report concerns a 65 year-old male patient with SBP and pneumoperitoneum. He has had a history of peptic ulcer. However, upon examination, no associated diseases or compromised immunity was detected. He presented with acute abdominal pain and subphrenic free air. An emergency laparotomy was performed, under the impression of a perforated peptic ulcer. Yet, no intraabdominal pathology except 200 ml of purulent ascites was found. The ascites culture yielded E. coli, B. fragilis, and P. aeruginosa confirming the diagnosis of SBP. Antibiotics which are sensitive to gas-forming bacteria should be prescribed before the result of the ascites culture is known.

Aged↗
PubMed2004

Complicated peptic ulcer disease in Tikur Anbessa Hospital, Addis Ababa.

There are few published surgical reports on peptic ulcer disease (PUD) in Ethiopia. Of 405 complicated peptic ulcer patients operated on in Tikur Anbessa Hospital, Addis Ababa, from 1997 to 2001, the records of 351 patients were retrieved and retrospectively analyzed to assess the pattern of PUD complication and the outcome of surgical treatment. During the study period, complicated PUD patients comprised 3.8% of the total major surgical procedures. The male to female ratio was 5.6: 1.0. The mean age was 36.5 +/- 12.7 years. Of 351 patients, 337 (96%) had abdominal pain, in most epigastric, and 330 (94%) had vomiting as presenting complaints. Dehydration was observed in 44 (12.5%). Gastric outlet obstruction (GOO) was the commonest complication followed by perforation that necessitated surgical intervention. The commonest operative procedure was truncal vagotomy and drainage. Nearly 5.0% died in hospital, most from complicated perforated peptic ulcer. Follow-up was possible in 262 patients for a mean of 16.2 +/- 15.0 months. Dumping and diarrhea were observed in 2.7% and 0.4% of the patients, respectively. Bile reflux gastritis was encountered in 1.5%. Truncal vagotomy and drainage remained to be easily learnable procedures with acceptable morbidity and mortality rates.

Adult↗