Elective surgery for peptic ulcer is becoming rare with the use of more effective medical therapy. However, life threatening complications have not reduced in number. A retrospective study was carried out to compare perforation rates per 10,000 admissions, mortality rates from perforated duodenal ulcers per 10,000 admission and the proportion of patients with perforated duodenal ulcer who died, before and after the introduction of H2 receptor blockers in a large teaching hospital in South India. Perforation rates were not significantly different between the two periods under study. There was a small, but statistically significant (p = 0.047) drop in mortality per 10,000 admissions and a significant drop in proportion of patients with perforated ulcer who died (p = 0.028). Inspite of effective medical therapy, there is a subset of patients with duodenal ulcer who continue to perforate. Efforts should be directed towards identifying this subset and offering them early surgery. Mortality rates have not changed significantly.
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Rev Esp Enferm Dig
January 2025
Cirugía General y del Aparato Digestivo, Hospital Universitario 12 de Octubre.
Case report of a patient with a duodenal ulcer, initially treated with sclerosing agents, as is common practice for most bleeding ulcers. However, the evolution following this treatment is unusual. The patient developed secondary ischemic cholangitis, leading to extensive aerobilia and secondary portal pneumatosis, accompanied by inflammatory changes in the head of the pancreas.
View Article and Find Full Text PDFMorphologie
January 2025
Department of Digestive Surgery, Amiens Picardy University Hospital, 1, rondpoint du Pr-Cabrol, 80054 Amiens, France; Simplifying Care for Complex Patients, UR-UPJV 7518 SSPC, Clinical Research Unit, University of Picardie Jules-Verne, Amiens, France.
Introduction: The duodeno-pancreatic region is a highly vascularized area. The superior and posterior pancreaticoduodenal artery is a vessel primarily originating from the gastroduodenal artery. It exhibits rare anatomical variations, such as its emergence from the right branch of the hepatic artery, which we fortuitously identified during a cadaver dissection.
View Article and Find Full Text PDFCureus
November 2024
Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, IND.
Duodenal perforation often presents as an acute onset of abdominal pain and potential complications such as systemic infection, multiple organ system failure, and even death. It can result from various causes, including peptic ulcer disease (PUD), trauma, malignancies, and infections. Prompt diagnosis and timely intervention are critical for better outcomes, though mortality can be high, particularly in delayed cases.
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November 2024
Accident and Emergency, Pilgrim Hospital, United Lincolnshire Hospitals Trust, Boston, GBR.
Epigastric pain and vomiting are common presentations associated with various causes of acute abdomen. Acute abdomen encompasses a range of different pathologies, with epigastric pain narrowing the differential diagnosis to conditions such as pancreatitis, bowel obstruction, acute cholecystitis, gastritis, acute coronary syndrome (ACS), and peptic ulcer disease, such as gastric ulcers and duodenal ulcers with/without perforation. This is a case of a male patient in his 80s who came to the emergency department with symptoms of generalized abdominal pain, vomiting, and constipation.
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