Group A patients were younger (t test, P 0.01) and more likely to present with perforation, whereas patients in group B presented with a combination of symptoms (chi square, P 0.03).[ncbi.nlm.nih.gov]
Patients presenting with acute mesenteric ischaemia alone face a high mortality rate as high as 60% whereas those presenting with peptic ulcer perforation the mortality rates range from 6-14%.[ncbi.nlm.nih.gov]
Prompt diagnosis and early therapy is needed to prevent death and prolonged serious illness, and the key to the diagnosis is an awareness of its frequent atypical presentations.[ncbi.nlm.nih.gov]
The present study aims to provide an applicability of laparoscopic gastrectomy used in the treatment of giant duodenal ulcer perforation.[ncbi.nlm.nih.gov]
Here, we present the case of a 53-year-old man with a hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation.[ncbi.nlm.nih.gov]
The video shows the management of a 51-year-old woman who came to the emergency room with acute abdomen, leukocytosis, and fever. Laparoscopy showed peritonitis with apparent gastric perforation. Duodenal perforation was confirmed by endoscopy.[ncbi.nlm.nih.gov]
Case 2 A 11-month-old male child was admitted with 10 days history of fever, rashes, and vesicular eruptions over the body, and a probable diagnosis of measles was made.[afrjpaedsurg.org]
A 55-year-old man presented after 3 weeks of sharp epigastric pain radiating to the right upper quadrant, fever, and generalized weakness. He had a history of significant heroin and cocaine abuse and was currently in a methadone maintenance program.[mdedge.com]
In addition, other diagnostic tools include temperature measurement as elevated fevers are common and blood pressure monitoring because a drop in blood pressure is not uncommon for the affected.[stomachbloating.net]
Abstract We wish to report a 14-year-old male adolescent who presented with sudden onset epigastric followed by right sided abdominal pain, vomiting and fever.[jpss.eu]
The most common sign of the deadly condition is a sudden and severepain in your abdomen. This pain will steadily get worse. If you experience this kind of pain it is vital to see your GP as soon as possible, or dial NHS 111.[thesun.co.uk]
While at work I started having severepains in my left side that radiated to my back. I was dumb enough to think that if I just went home to lie down I would be fine...and drove myself home with this mind numbing pain.[patient.info]
Severepain, systemic inflammatory response from chemical peritonitis and fluid deficit either due to poor intake or vomiting or pyrexia leads to compensatory tachycardia.[wjgnet.com]
All patients came with complains of severepain in abdomen. The pain was associated with multiple episodes of non-bilious vomiting. Surprisingly none of them presented with fever.[webmedcentral.com]
We report a case of a 30-year-old male patient with abdominalpain and respiratory distress. Resulting from physical examination and laboratory data of the patient, acute abdomen and pneumothorax were diagnosed simultaneously.[ncbi.nlm.nih.gov]
On admission, the patient complained of severe acute abdominalpain, with physical examination findings suspicious for a perforated peptic ulcer.[ncbi.nlm.nih.gov]
The patient complained of abdominalpain for the last 12 hours with two episodes of vomiting in the last five hours and complete constipation for two days.[cureus.com]
Materials and Methods: Three young male patients presenting with a short duration history of abdominalpain and vomiting and chest radiograph suggesting pneumoperitoneum were selected for endoscopic clipping.[jdeonline.in]
Abstract We wish to report a 14-year-old male adolescent who presented with sudden onset epigastric followed by right sided abdominalpain, vomiting and fever.[jpss.eu]
Links: haematemesis right upper quadrant pain right iliac fossa pain (RIF) epigastricpain[gpnotebook.co.uk]
Figure 1 A 48-year-old man who was receiving medical treatment for peptic ulcer disease experienced intense epigastricpain, sudden in onset and without emesis, four hours before admission.[nejm.org]
Epigastricpain is a typical symptom of PUD, however, some patients may remain asymptomatic until complications such as bleeding and perforation occur.[amboss.com]
A 55-year-old man presented after 3 weeks of sharp epigastricpain radiating to the right upper quadrant, fever, and generalized weakness. He had a history of significant heroin and cocaine abuse and was currently in a methadone maintenance program.[mdedge.com]
Pneumothorax and pneumomediastinum are rarely observed as a complication of perforated peptic ulcer, which is a common cause of acuteabdomen. We report a case of a 30-year-old male patient with abdominal pain and respiratory distress.[ncbi.nlm.nih.gov]
The video shows the management of a 51-year-old woman who came to the emergency room with acuteabdomen, leukocytosis, and fever. Laparoscopy showed peritonitis with apparent gastric perforation. Duodenal perforation was confirmed by endoscopy.[ncbi.nlm.nih.gov]
Perforated duodenal ulcer a rare cause of acuteabdomen in infancy: A report of two cases. Afr J Paediatr Surg [serial online] 2008 [cited 2018 Nov 24];5:46-7.[afrjpaedsurg.org]
Although sonography is useful as a first-line diagnostic tool for acuteabdomen in the emergency department, it is less helpful in the diagnosis of peptic ulcer perforation.[academic.oup.com]
Perforated ulcers usually present with an acuteabdomen and are life-threatening unless immediately recognized and treated.[mdedge.com]
Severeabdominalpain in a significantly sick adolescent associated with rigid abdomen and signs of shock should prompt one to think of possible peptic perforation. Atypical and puzzling presentations have been reported [4-5].[jpss.eu]
Severeabdominalpain with or without evidence of bleeding may indicate a perforation of the ulcer through the stomach or duodenum.[mountsinai.org]
Clinical features The patient presents with sudden onset of severeabdominalpain. The onset of pain is so sudden that the patient can often accurately pin-point the exact moment when the perforation occurred.[surgwiki.com]
Other factors such as shock (hypotension) and comorbidities have also been described as factors contributing to poor response to conservative approach, as well as associated with higher mortality [5-6] .[cureus.com]
Fever, hypotension, and oliguria suggest sepsis and circulatory compromise.[aafp.org]
Hypotension, tachycardia or high fever are signs of gravity.[omicsonline.org]
Patients with bleeding ulcers may report passage of black tarry stools (melena), weakness , a sense of light-headedness or ay even pass out upon standing ( orthostatic hypotension or syncope ) and vomiting blood (hematemesis).[medicinenet.com]
Hypotension is a late finding as is a high fever. The abdominal findings are characteristically described as of board-like rigidity.[ncbi.nlm.nih.gov]
On examination: patient looks ill and lies unusually still in pain tachycardia shallow respiration Inspection: abdomen is flat - does not fall and rise with respiration Palpation: very tender, intense guarding & "board-like" rigidity Percussion: if air[gpnotebook.co.uk]
Pain was the consistent symptom while tachycardia, tenderness, and guarding were the signs present in all 70 (40%) patients. Gas under diaphragm (pneumoperitoneum) was found in 67 (95.71%).[scopemed.org]
On examination the child was dehydrated, anicteric, had tachycardia and tachypnoea. Abdominal examination revealed guarding and rebound tenderness suggestive of perforation peritonitis.[afrjpaedsurg.org]
The chemical peritonitis due to efflux of gastroduodenal contents and severe pain lead to tachycardia. The classic triad of sudden onset of abdominal pain, tachycardia and abdominal rigidity is the hallmark of PPU.[wjgnet.com]
Then presence of clinical features pain, vomiting, fever, abdominal distension, tenderness, guarding / rigidity, tachycardia, shock were recorded.[webmedcentral.com]
After a brief history and physical examination in the emergency room, the patient was admitted and a thorough workup panel was requested.[cureus.com]
His workup revealed an elevated white blood cell count, gallstones, gallbladder wall thickening and pericholecystic fluid on his right upper quadrant ultrasound, and an upright chest xray without free air.[sages.org]
Victims of penetrating trauma with signs of peritonitis require surgical exploration without further diagnostic workup.[wjes.biomedcentral.com]
Materials and Methods: Three young male patients presenting with a short duration history of abdominal pain and vomiting and chest radiograph suggesting pneumoperitoneum were selected for endoscopic clipping.[jdeonline.in]
A chest film (Panel A) showed bilateral pneumoperitoneum (arrows). An exploratory laparotomy revealed a perforated duodenal ulcer with callous borders (Panel B).[nejm.org]
Gas under diaphragm (pneumoperitoneum) was found in 67 (95.71%).[scopemed.org]
Switch off gas when desired pneumoperitoneum is created & remove the Veress needle Port location A 10mm camera port is placed in the umbilicus; this position will vary according the build of the patient.[laparoscopyhospital.com]
A perforated peptic ulcer is the first differential diagnosis of pneumoperitoneum, but in the socio-epidemiological context of Togo, one should also consider typhoid.[medical-dictionary.thefreedictionary.com]
It showed an atelectasis of the right lung base (Figures 1 and 2). The diagnosis of acute bronchopneumonia was made and our patient was given medical therapy with antibiotic (amoxicillin/clavulanic acid).[oatext.com]
Simple closure, with or without H2 antagonist treatment, was the most popular management of a perforated acute duodenal ulcer.[ncbi.nlm.nih.gov]
These results compare favorably with reports for the elective treatment of duodenal ulcer with vagotomy and pyloroplasty.[ncbi.nlm.nih.gov]
Pylori positive) received postoperative H. pylori eradication treatment, and Group 2 (H. pylori negative) received only lansaprasol treatment after surgery.[ncbi.nlm.nih.gov]
In this study, we analysed the outcome of treatment in terms of complications, mortality and hospital stay with relevant to laparoscopy and open approach.[ncbi.nlm.nih.gov]
Surgery is the mainstay of treatment of patients with peptic duodenal perforation. With the advent of minimal access techniques, laparoscopy is being used for the treatment of this condition.[ncbi.nlm.nih.gov]
Early management in the intensive care unit and appropriate surgical intervention maximised the patient's chances of survival despite the poor prognosis associated with her dual pathology.[ncbi.nlm.nih.gov]
Figure 1: Chest radiograph suggestive of free gas under both domes of diaphragm Click here to view Discussion DUP is a common surgical emergency. [1] It has good prognosis with timely and appropriate intervention.[jdeonline.in]
Female sex, more coexisting clinical events, no evidence of chronic ulcer, and treatment by simple suture were associated with significant poor prognosis on univariate analysis.[jpss.eu]
Prognosis of gastric cancer stays dependent on tumour stage and seems not to be worsened by the perforation itself. Postoperative pain and rate of wound infections are lower after laparoscopic operation for perforated peptic ulcer.[thieme-connect.com]
Original Articles Keywords : Peptic ulcer, perforation, Boey score, prognosis Abhishek Agarwal, Sanchit Jain, LN Meena, Sumita A Jain, Lakshman Agarwal Department of General Surgery, SMS Medical College, Jaipur, India Corresponding Author : Dr.[tropicalgastro.com]
Etiology Risk factors Chronic gastritis caused by H. pylori , a curved, flagellated gram-negative rod Duodenal ulcers : up to 90% are due to H. pylori infection Gastric ulcers : up to 80% are due to H. pylori infection Chronic gastritis of other etiology[amboss.com]
Prematurity, Etiology and Management. Postgraduate Medicine, 35, 2 (Feb.) : 185-188. Expert Committee on Maternal and Child Health, 1961. Public Health Aspects of Low Birth Rate, WHO Technical Report Series, No. 217. Gregory, I., 1962.[books.google.es]
NSAID is one of the contributing etiological factors. Early diagnosis and timely management is advocated to reduce morbidity and mortality.[webmedcentral.com]
Helicobacter pylori is not the predominant etiology for peptic ulcers requiring operation. Am Surg 2011; 77:1054-1060. 2. Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg 2010; 27:161-169. 3.[ejs.eg.net]
The etiology of gastrointestinal perforations in the newborn. J Pediatr Surg 1969; 4: 77-80. [ PUBMED ] [ FULLTEXT ] 8. Hernandez DS, Rodrigulz AG.[afrjpaedsurg.org]
To provide updated epidemiological data on duodenal ulcer perforation, the incidence of the disease in Norfolk, United Kingdom was determined.[ncbi.nlm.nih.gov]
A perforated peptic ulcer is the first differential diagnosis of pneumoperitoneum, but in the socio-epidemiological context of Togo, one should also consider typhoid.[medical-dictionary.thefreedictionary.com]
Epidemiology References: [1] [2] [3] [4] [5] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
Sonnenberg A, Sengupta A, Bauerfeind P (1988) Epidemiology of peptic ulcer disease. In: MRCP WDWRM, editor. Advances in Peptic Ulcer Pathogenesis [Internet]. Springer Netherlands; 1988: 1-31.[omicsonline.org]
Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion 2011; 84:102-113. 4. Williams N, Bullstrode C, Connell RO.[ejs.eg.net]
This is the first report of massive bowel ischaemia and duodenal perforation with no apparent underlying common pathophysiology leading to this presentation.[ncbi.nlm.nih.gov]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 51. Updated by: Michael M.[medlineplus.gov]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 53. Ford AC, Gurusamy KS, Delaney B, Forman D, Moayyedi P.[mountsinai.org]
References: [12] Pathophysiology Clinical features Gastric ulcer Duodenal ulcer Findings common to both Dyspepsia : postprandial heaviness, early satiety , and gnawing, aching or burning epigastric pain Pain relief with antacids Potential signs of internal[amboss.com]
Despite better understanding of pathophysiology and medical therapy of acid peptic disease, duodenal ulcer perforation remains one of the major cause of Peritonitis. 1,2 The incidence of perforated peptic ulcer in western countries is 7 to 9 per 1,00,000[webmedcentral.com]
Prompt diagnosis and early therapy is needed to prevent death and prolonged serious illness, and the key to the diagnosis is an awareness of its frequent atypical presentations.[ncbi.nlm.nih.gov]
Eradication of H. pylori prevents ulcer recurrence in patients with H. pylori-associated perforated duodenal ulcers. Immediate acid-reduction surgery in the presence of generalized peritonitis is unnecessary.[ncbi.nlm.nih.gov]
This volume offers authoritative, evidence-based recommendations for preventing and managing complications in all current general surgery procedures.[books.google.com]
Considering the compromised state of such patients, endoscopic treatment and avoiding surgery will play a great role in preventing the further stress caused by surgery and facilitate quicker recovery.[jdeonline.in]
Prevention Avoid aspirin, ibuprofen, naproxen, and other NSAIDs. Try acetaminophen instead. If you must take such medicines, talk to your provider first.[mountsinai.org]