Gastric Antral Diverticula: A Rare Diverticula with a Unique Presentation

Gastric diverticula are the least common gastrointestinal diverticula. Patients can be diagnosed incidentally on EGD or present with variable symptoms such as abdominal fullness, anorexia, and perforation. Gastric diverticula can be acquired from malignancy, peptic ulcer disease, or prior surgery or be congenital. Treatment varies based on symptomatology ranging from conservative medical management with proton pump inhibitors to surgical treatment with open or laparoscopic resection. We present a case of a 73-year-old female with acquired gastric diverticulum presenting as a gastric outlet obstruction who was successfully treated with conservative medical therapy.

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Temporal Trends of Peptic Ulcer Disease in Kashmir, India

JMS SKIMS ◽

10.33883/jms.v15i2.251 ◽

2012 ◽

Vol 15 (2) ◽

pp. 136-140

Author(s):

G M Gulzar ◽

Showkat A Zargar ◽

Muzaffar Nazir ◽

Gul Javid ◽

Bashir A Khan ◽

...

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Gastric Outlet Obstruction ◽

Temporal Trends ◽

Outlet Obstruction ◽

Life Time ◽

Point Prevalence ◽

Asymptomatic Group ◽

Ulcer Disease ◽

Ulcer Perforation

BACKGROUND: Since late 1960s, the prevalence of peptic ulcer disease and its complications has been steadily decreasing. OBJECTIVE: To ascertain the changing trends in the prevalence and complications of peptic ulcer in Kashmir. METHODS: A cohort of 10474 people aged 15-60 years in district Baramulla of Kashmir was interviewed about symptoms, complications, and surgery related to peptic ulcer. People were enquired about smoking, use of NSAIDs, H2 Receptor antagonists, proton pump inhibitors and endoscopies. All symptomatic and randomly selected group of asymptomatic people underwent esophago-gastro-cluodenoscopy. RESULTS: In symptomatic group, 286 (41.45%) people hod peptic ulcer and in asymptomatic group 24 (5.35%) had peptic ulcer. There were 71 already diagnosed cases of peptic ulcer; totaling 381. Thirty three people had surgery for peptic ulcer. The point prevalence of peptic ulcer was 3.54% and lifetime prevalence 8.96%. The highest prevalence was in 4th decade. Bleeding was seen in 23.63%, gastric outlet obstruction 4.20%, ulcer perforation 0.52%. 9.39% of peptic ulcer patients had undergone surgery. When compared to previous study in 1985 in Kashmir, there was decrease in point prevalence of 25%, in life-time prevalence of 20.14%, Gastric outlet obstruction by 51.7%, ulcer perforation by 87%, surgery rate by 60% and bleeding by a marginal 2%. CONCLUSION: Prevalence of peptic ulcerand its complications (except bleeding) are showing downward trend in Kashmir over the last 20 years. JMS 2012;15(2):136-40

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Proton Pump Inhibition is a Feasible Primary Alternative to Surgery and Balloon Dilatation in Adult Peptic Pyloric Stenosis (APS): Report of Six Consecutive Cases

Annals of The Royal College of Surgeons of England ◽

10.1308/003588406x94959 ◽

2006 ◽

Vol 88 (2) ◽

pp. 174-175 ◽

Cited By ~ 4

Author(s):

J Shabbir ◽

S Durrani ◽

PF Ridgway ◽

K Mealy

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Pyloric Stenosis ◽

Median Duration ◽

Oral Treatment ◽

Duration Of Symptoms ◽

Ulcer Disease ◽

Proton Pump Inhibition

INTRODUCTION Surgery has been the gold standard in the treatment of adult pyloric stenosis (APS). The introduction of proton pump inhibitors (PPIs) in 1989 revolutionised the treatment of peptic ulcer disease and its complications. PATIENTS AND METHODS We carried out a prospective study to evaluate the effectiveness of PPIs as an alternative to surgery for treatment of APS. Six consecutive patients admitted with a diagnosis of adult peptic pyloric stenosis between November 1999 and August 2002 were studied. The diagnosis was confirmed with endoscopy. All patients were commenced on a twice-daily dose of intravenous PPI. This was changed to oral treatment after 2 days. Main outcome measures evaluated were resolution of symptoms on PPIs and failure of medical therapy. RESULTS There were five females and one male. Median age at diagnosis was 72 years (range, 30–90 years). Median duration of symptoms was 2 weeks (range, 1–5 weeks). Of the patients, five had a history of peptic ulcer disease. Complete resolution was achieved in 5 patients (83%). Median duration for resolution of symptoms was 9 days (range, 5–14 days). All patients were changed to oral PPIs after 2 days. One patient did not respond to oral therapy and required surgical intervention (pyloroplasty). Median follow-up was 26 months (range, 6–48 months). There was no recurrence of symptoms. All patients were discharged on low-dose PPI. CONCLUSIONS This study supports the view that proton pump inhibitors are a safe and feasible alternative to surgery in adult pyloric stenosis secondary to peptic ulcer disease.

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