scholarly journals Two Cases of Perforated Peptic Ulcer Occurring as Postoperative Complications of Esophagectomy with Jejunal Interposition

1959 ◽  
Vol 149 (4) ◽  
pp. 586 ◽  
Author(s):  
Gustav Bansmer ◽  
Alexander H. Bill ◽  
Dean K. Crystal
Keyword(s):  
Peptic Ulcer ◽  
Postoperative Complications ◽  
Perforated Peptic Ulcer ◽  
Jejunal Interposition

scholarly journals Predicting the Amount of Intraperitoneal Fluid Accumulation by Computed Tomography and Its Clinical Use in Patients With Perforated Peptic Ulcer

2014 ◽  
Vol 99 (6) ◽  
pp. 824-829 ◽  
Author(s):  
Toru Ishiguro ◽  
Youichi Kumagai ◽  
Hiroyuki Baba ◽  
Yusuke Tajima ◽  
Hideko Imaizumi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Peptic Ulcer ◽  
Postoperative Complications ◽  
Ct Scan ◽  
Peritoneal Fluid ◽  
Treatment Decision ◽  
Perforated Peptic Ulcer ◽  
Clinical Parameters ◽  
Treatment Decision Making ◽  
The Relationship

Abstract The correlation between the amount of peritoneal fluid and clinical parameters in patients with perforated peptic ulcer (PPU) has not been investigated. The authors' objective was to derive a reliable formula for determining the amount of peritoneal fluid in patients with PPU before surgery, and to evaluate the correlation between the estimated amount of peritoneal fluid and clinical parameters. We investigated 62 consecutive patients who underwent emergency surgery for PPU, and in whom prediction of the amount of accumulated intraperitoneal fluid was possible by computed tomography (CT) using the methods described by Oriuchi et al. We examined the relationship between the predicted amount of accumulated intraperitoneal fluid and that measured during surgery, and the relationship between the amount of fluid predicted preoperatively or measured during surgery and several clinical parameters. There was a significant positive correlation between the amount of fluid predicted by CT scan and that measured during surgery. When patients with gastric ulcer and duodenal ulcer were analyzed collectively, the predicted amount of intraperitoneal fluid and the amount measured during surgery were each associated with the period from onset until CT scan, perforation size, the Mannheim peritoneal index, and the severity of postoperative complications according to the Clavien–Dindo classification. Our present results suggest that the method of Oriuchi et al is useful for predicting the amount of accumulated intraperitoneal fluid in patients with PPU, and that this would be potentially helpful for treatment decision-making and estimating the severity of postoperative complications.

scholarly journals Postoperative Morbidity and Mortality of Perforated Peptic Ulcer: Retrospective Cohort Study of Risk Factors among Black Africans in Côte d’Ivoire

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Soro Kountele Gona ◽  
Mahassadi Kouamé Alassan ◽  
Koffi Gnangoran Marcellin ◽  
Kissi Ya Henriette ◽  
Coulibaly Adama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Cohort Study ◽  
Postoperative Complications ◽  
Hospital Admission ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Surgical Intervention ◽  
Perforated Peptic Ulcer ◽  
Delayed Time

Introduction. Surgical treatment of perforated peptic ulcer (PPU) is a challenge for surgeons in Africa.Aim. To determine risk factors of postoperative complications or mortality among black Ivoirian patients with PPU.Methods. All 161 patients (median age = 34 years, 90.7 male) operated on for PPU in the visceral and general surgery unit were enrolled in a retrospective cohort study. Variables were studied with Kaplan Meier and Cox proportional hazard models.Results. Among 161 patients operated on for PPU, 36 (27.5%) experienced complications and 31 (19.3%) died. Follow-up results were the incidence of complications and mortality of 6.4 (95% CI: 4.9–8.0) per 100 person-days and 3.0 (95% CI: 1.9–4.0) per 100 person-days for incidence of mortality. In multivariate analysis, risk factors of postoperative complications or mortality were comorbidities (HR = 2.1,P=0.03), tachycardia (pulse rate > 100/minutes) (HR = 2.4,P=0.02), purulent intra-abdominal fluid collection (HR = 2.1,P=0.04), hyponatremia (median value ≤ 134 mEq/L) (HR = 2.3,P=0.01), delayed time of hospital admission > 72 hours (HR = 2.6,P<0.0001), and delayed time of surgical intervention between 24 and 48 hours (HR = 3.8,P<0.0001).Conclusion. The delayed hospital admission or surgical intervention and hyponatremia may be considered as additional risk of postoperative complications or mortality in Black African patients with PPU.

Primary laparoscopic approach to repair perforated peptic ulcer. A retrospective cohort study

2020 ◽  
Vol 75 (6) ◽  
Author(s):  
Gianrocco Manco ◽  
Stefania Caramaschi ◽  
Giovanni Rolando ◽  
Marzio Malagoli ◽  
Giuliana Zanelli ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Laparoscopic Approach ◽  
Perforated Peptic Ulcer

scholarly journals Decreased risk of liver and intrahepatic cancer in non-H. pylori-infected perforated peptic ulcer patients with truncal vagotomy: a nationwide study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shih-Chi Wu ◽  
Han-Tsung Cheng ◽  
Yu-Chun Wang ◽  
Chia-Wei Tzeng ◽  
Chia-Hao Hsu ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Asian Population ◽  
Perforated Peptic Ulcer ◽  
Truncal Vagotomy ◽  
Research Database ◽  
Cancer History ◽  
Simple Closure ◽  
H Pylori

AbstractThe vagal nervous system is central to the physiological responses and systemic diseases of the liver. We evaluated the subsequent risk of liver and intrahepatic cancer (HCC/ICC) in non-H. pylori (HP)-infected perforated peptic ulcer (PPU) patients with and without vagotomy. Hospitalized PPU patients who underwent simple closure or truncal vagotomy/pyloroplasty (TVP) in the National Health Insurance Research Database from 2000 to 2008 were enrolled. The exclusion criteria included: (1) Multiple surgeries for PPU were received at the same admission; (2) Any cancer history; (3) Previous peptic ulcer-associated surgery; (4) HP infection history; (5) Viral hepatitis infection history; (6) Follow-up duration < 1 year; and (7) Age < 18 years. The risks of developing HCC/ICC in PPU patients with and without vagotomy were assessed at the end of 2013. To balance the baseline condition between groups, we used the propensity score matched method to select study subjects. Cox proportional hazard regression was used to estimate the hazard ratio and 95% confidence interval (CI) of HCC/ICC. Before propensity score matching, 675 simple suture patients and 54 TVP patients had HCC/ICC, which corresponded to incidences of 2.11 and 0.88 per 1000 person-years, respectively. After propensity score matching, 145 simple suture patients and 54 TVP patients experienced HCC/ICC, which corresponded to incidences of 1.45 and 0.88 per 1000 person-years, respectively. The TVP patients had a 0.71 (95% CI 0.54–0.95)- and 0.69 (95% CI 0.49–0.97)-fold risk of developing HCC/ICC compared to simple suture patients before and after propensity score matching. Our findings reported that, in the Asian population, TVP decreases the risk of HCC/ICC in non-HP-infected PPU patients compared to simple closure patients. However, further studies are warranted.

scholarly journals Patients With Perforated Peptic Ulcers: Risk Factors for Morbidity and Mortality

2019 ◽  
Vol 103 (11-12) ◽  
pp. 578-584
Author(s):  
Fatih Ciftci ◽  
Fazilet Erözgen
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Postoperative Period ◽  
Perforated Peptic Ulcer ◽  
Apache Ii ◽  
Morbidity And Mortality ◽  
Apache Ii Score ◽  
Peptic Ulcers ◽  
Presentation Time ◽  
Independent Risk Factors

Perforated peptic ulcers continue to be an important problem in surgical practice. In this study, risk factors for peptic ulcer perforation-associated mortality and morbidity were evaluated. This is a retrospective study of patients surgically treated for perforated peptic ulcer over a decade (March 1999–December 2014). Patient age, sex, complaints at presentation, time lapse between onset of complaints and presentation to the hospital, physical findings, comorbidities, laboratory and imaging findings, length of hospitalization, morbidity, and mortality were recorded. The Mannheim peritonitis index (MPI) and Acute Physiology and Chronic Health Evaluation (APACHE) II score were calculated and recorded for each patient on admission to the hospital. Of the 149 patients, mean age was 50.6 ± 19 years (range: 17–86). Of these, 129 (86.5%) were males and 20 (13.4%) females. At least 1 comorbidity was found in 42 (28.1%) of the patients. Complications developed in 36 (24.1%) of the patients during the postoperative period. The most frequent complication was wound site infection. There was mortality in 26 (17.4%) patients and the most frequent cause of mortality was sepsis. Variables that were found to have statistically significant effects on morbidity included age older than 60 years, presence of comorbidities, and MPI (P = 0.029, 0.013, and 0.013, respectively). In a multivariate analysis, age older than 60 years, presence of comorbidities, and MPI were independent risk factors that affected morbidity. In the multivariate logistic regression analysis, age older than 60 years [P = 0.006, odds ratio (OR) = 5.99, confidence interval (CI) = 0.95] and comorbidities (OR = 2.73, CI = 0.95) were independent risk factors that affected morbidity. MPI and APACHE II scoring were both predictive of mortality. Age older than 60, presentation time, and MPI were independent risk factors for mortality. Undelayed diagnosis and appropriate treatment are of the utmost importance when presenting with a perforated peptic ulcer. We believe close observation of high-risk patients during the postoperative period may decrease morbidity and mortality rates.

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