scholarly journals 794 Diagnostic Pitfall in Atypical Presentation of Malignant Gastric Ulcer Perforation

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M K Oo ◽  
T N Tun ◽  
M Aung
Keyword(s):  
Gastric Ulcer ◽  
Abdominal Pain ◽  
Symptom Control ◽  
Chronic Abdominal Pain ◽  
Clinical Deterioration ◽  
Early Warning Score ◽  
Peptic Ulcer Perforation ◽  
Atypical Presentation ◽  
Clinical Frailty Scale ◽  
Ulcer Perforation

Abstract Background Peptic ulcer perforation is one of the most common surgical problems in daily practice. Although it can be easily diagnosed clinically, the clinical presentation can be less obvious in some cases leading to diagnostic pitfalls and mortality. This case report aims to highlight an atypical presentation of malignant gastric ulcer perforation in a patient with chronic abdominal pain. Case presentation A 78-year-old lady presented with chronic abdominal pain for 3 months. Investigations and imaging revealed T2N1M0 malignant gastric ulcer which was confirmed by endoscopy. Due to her low body mass index and underlying comorbidities, she was admitted for pre-operative optimization. However, she was a good 78 with the clinical frailty scale 4 and the National Early Warning Score 0 throughout the stay. On the night before the operation, she suddenly developed delirium. Further history revealed marked oliguria for 12 hours. There was mild abdominal distension without peritonism. She was catheterized and treated with fluids and antibiotics. X-ray suggested massive pneumoperitonium. Subsequently, she developed full-blown septic shock with rapid clinical deterioration within 3 hours. With the estimated Boey scoring of 3 and rapid clinical deterioration, the symptom control approach was decided. A palliative bedside ascitic tap was performed to relieve the discomfort. Four hours after the onset, unfortunately, the patient passed away. Conclusions Although gastric ulcer perforation usually presents with obvious symptoms, extra precaution should be exercised in elderly patients with chronic abdominal pain and comorbidities. We could learn that routine monitoring of urine output might aid in the early diagnosis of sepsis.

scholarly journals Correlation Between Candidiasis And Mortality In Gastric Ulcer Perforation Patients

2021 ◽  
Vol 5 (11) ◽  
pp. 1037-1041
Author(s):  
Faradina Sulistiyani ◽  
Vicky Sumarki Budipramana ◽  
Pepy Dwi Endraswari
Keyword(s):  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
General Hospital ◽  
Gastrointestinal Disease ◽  
Perforated Peptic Ulcer ◽  
Cross Sectional Study ◽  
Peptic Ulcer Perforation ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
Ulcer Perforation

Background: Gastric ulcer disease remains the most common gastrointestinal disease. This affects about 4 million people every year worldwide with an incidence of 1.5%-3% and 2-14% of these will progress to perforation. Mortality is reported in 30% of cases and caused morbidity in 50% of patients. Some studies have suggested that mortality in patients with peritonitis accompanied by candidiasis ranges from 20%-75%, whereas others have argued that the presence of fungal isolates in patients with perforated peptic ulcer does not affect the outcome. A recent study reported an incidence of 45% of patients peptic ulcer perforation cases accompanied by candidiasis in Dr. Soetomo General Hospital Surabaya in 2019.Methods: This was a cross sectional study based on medical record data of patients with gastric ulcer perforation accompanied by candidiasis who underwent laparotomy and gastric repair surgery at Dr. Soetomo General Hospital Surabaya from January 2019 to December 2020.Results: There was no significant correlation between candidiasis and mortality in gastric ulcer perforation patients (p=0.989).Conclusion: Candidiasis does not increase mortality in patients with gastric ulcer perforation.

scholarly journals Correlation Between Candidiasis And Mortality In Gastric Ulcer Perforation Patients

2021 ◽  
Vol 5 (4) ◽  
pp. 947-952
Author(s):  
Faradina Sulistiyani ◽  
Vicky Sumarki Budipramana ◽  
Pepy Dwi Endraswari
Keyword(s):  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
General Hospital ◽  
Gastrointestinal Disease ◽  
Perforated Peptic Ulcer ◽  
Cross Sectional Study ◽  
Peptic Ulcer Perforation ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
Ulcer Perforation

Background: Gastric ulcer disease remains the most common gastrointestinal disease. This affects about 4 million people every year worldwide with an incidence of 1.5%-3% and 2-14% of these will progress to perforation. Mortality is reported in 30% of cases and caused morbidity in 50% of patients. Some studies have suggested that mortality in patients with peritonitis accompanied by candidiasis ranges from 20%-75%, whereas others have argued that the presence of fungal isolates in patients with perforated peptic ulcer does not affect the outcome. A recent study reported an incidence of 45% of patients peptic ulcer perforation cases accompanied by candidiasis in Dr. Soetomo General Hospital Surabaya in 2019.Methods: This was a cross sectional study based on medical record data of patients with gastric ulcer perforation accompanied by candidiasis who underwent laparotomy and gastric repair surgery at Dr. Soetomo General Hospital Surabaya from January 2019 to December 2020.Results: There was no significant correlation between candidiasis and mortality in gastric ulcer perforation patients (p=0.989).Conclusion: Candidiasis does not increase mortality in patients with gastric ulcer perforation.

scholarly journals Efficacy of Acupuncture in the Treatment of Chronic Abdominal Pain

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Amnon A. Berger ◽  
Yao Liu ◽  
Kevin Jin ◽  
Alicia Kaneb ◽  
Alexandra Welschmeyer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Abdominal Pain ◽  
Adult Population ◽  
Symptom Control ◽  
Chronic Abdominal Pain ◽  
Emergency Situations ◽  
Complementary Approach ◽  
Chronic Pain Conditions

Context: Abdominal pain is a widespread complaint and is one of the common reasons leading patients to seek medical care, either in emergency situations or with their primary providers. While acute abdominal pain is a better defined, usually surgical condition, chronic abdominal pain requires longer, typically lifelong, therapy. Chronic abdominal pain may also present with acute flares and complications. Here we review seminal and novel evidence discussing the use of acupuncture in the treatment of abdominal pain, indications, and conditions that may benefit from this approach. Evidence Acquisition: Chronic abdominal pain is a common complaint causing significant morbidity and disability and has a hefty price tag attached. Recent studies show it may be prevalent in as much as 25% of the adult population. It is defined as three episodes of severe abdominal pain over the course of three months. Chronic abdominal pain could be the result of chronicity of acute pain or of chronic pain syndromes, most commonly IBD syndromes and IBS. While a plethora of treatments exists for both conditions, these treatments usually fall short of complete symptom control, and there is a need for complementary measures to curb disability and increase the quality of life in these patients. Acupuncture is a form of integrative medicine that has long been used in Chinese and traditional medicine, based on the rebalancing of the patient’s Qi, or Ying/Yang balance. It has been shown to be effective in treating several other conditions, and novel evidence may expand its use into other fields as well. Clinical trials studying acupuncture in chronic pain conditions have been promising, and recent evidence supports the use of abdominal pain in chronic abdominal pain conditions as well. Though not curative, acupuncture is a complementary approach that helps reduce symptoms and improved quality of life. Conclusions: Chronic abdominal pain is a widespread condition, mostly affected by the IBS and IBD spectrum. Etiologies are still being studied for these conditions, and while novel treatment approaches are absolute game changers for these patients, many continue to experience some level of symptoms and disability. Acupuncture may provide further alleviation of these symptoms in select patients, thus improving quality of life, reducing disability, and saving healthcare dollars. It is a largely safe and inexpensive method that may significantly contribute to the quality of life of selected patients.

scholarly journals A Rare Cause of Acute Abdominal Pain in Childhood: Peptic Ulcer Perforation

2018 ◽  
Vol 5 (3) ◽  
pp. 149-152
Author(s):  
Ali Yurtseven ◽  
Mehtap Küçük ◽  
Zafer Dökümcü ◽  
Caner Turan ◽  
Eylem Ulaş Saz
Keyword(s):  
Peptic Ulcer ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Peptic Ulcer Perforation ◽  
Ulcer Perforation

scholarly journals Surgical treatment of perforated gastric ulcer

2002 ◽  
Vol 55 (11-12) ◽  
pp. 513-516 ◽  
Author(s):  
Milan Korica ◽  
Goran Petakovic ◽  
Sava Gavrilovic
Keyword(s):  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Surgical Procedures ◽  
Postoperative Mortality ◽  
Perforated Peptic Ulcer ◽  
Peptic Ulcer Perforation ◽  
Simple Closure ◽  
Ulcer Disease ◽  
Ulcer Perforation

Introduction Peptic ulcer perforation is a complication of ulcer disease which requires urgent surgical treatment. The aim of this paper was to point out our experience in surgical treatment of perforated peptic ulcer. Material and methods This retrospective study analyzes results of surgical treatment in 365 patients with perforated peptic ulcer during the period January 1996 to December 2000. Results During the last 5-year period 365 patients were treated following peptic ulcer perforation. The average age was 43.53?8.26, with the span from 18 to 86. The most frequent surgical procedures in treatment of peptic ulcer perforation were: simple closure with biopsy (55.88%), excision of the ulcer with a pyloroplasty and vagotomy (35.29%) as nonresection surgical procedures and stomach resection after Billroth II (8.83%). The postoperative mortality was 4.41%. Conclusions The methods of choice in surgical treatment of gastric ulcer perforation are nonresection surgical procedures with drug therapy and eradication of Helicobacter pylori, if present.

scholarly journals Laparoscopic Repair of Peptic Ulcer Perforation - Our Initial Experience

2014 ◽  
Vol 1 (2) ◽  
pp. 153-157
Author(s):  
Md. Saiful Hoque ◽  
Gazi Mohammad Zakir Hossain ◽  
Nur Hossain Bhuiyan ◽  
Md. Rashedul Hasan ◽  
Mayin Uddin Mahmud ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Laparoscopic Repair ◽  
Operation Time ◽  
Perforated Peptic Ulcer ◽  
Peptic Ulcer Perforation ◽  
Related Complication ◽  
Ulcer Perforation ◽  
Delayed Recovery ◽  
Duodenal Ulcer Perforation

Background: Laparoscopic repair of perforated peptic ulcer was reported in 1990 but has not gained wide acceptance. The aim of this study was to evaluate the safety and efficacy of laparoscopic repair in routine clinical practice.Methods: This was a prospective analysis of 30 patients who underwent laparoscopic repair of a perforated peptic ulcer between July 2009 and June2010.Results: Thirty patients of mean age 45 (range 25-52) years had perforated ulcer diagnosed by clinical examination and x-ray abdomen and confirmed by laparoscopy. 28 was duodenal ulcer perforation and rest 2 was gastric ulcer perforation. Only 3 patients required conversion to laparotomy out of them 2 were DU perforation and one was gastric ulcer perforation. Mean operation time was 75 (range 75-150) minutes. Mean postoperative hospital stay was 6 (5-10) days. Postoperative convalescences were good. There was no operation related complication but one patient needs transfer to ICU for delayed recovery and the patient eventually recovered well. Post-operative leakage occurred in one patient and that was treated by laparotomy. One of 3 conversion cases developed wound infection but wound related complications in laparoscopic cases were very negligibe.Conclusion: Laparoscopic repair is a safe and effective procedure for repair of perforated peptic ulcer.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19535

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