Complications of gastric and duodenal ulcers
From WikiLectures
Surgery should be considered for all complications of gastric and duodenal ulcers.
Bleeding[1]
- manifests as hematemesis or melena
- RF: ASA (acetylsalicylic acid), NSAID (non-steroidal anti-inflammatory drugs)
- diagnosis: endoscopy
Penetration
- gradual penetration through the entire wall into the surrounding area (duodenal ulcer into the pancreas)
- inflammation occurs, adhesions may form
- persistent pain, propagation to the back
- X-ray: deep plug
Unlike perforation, it does not penetrate into the free abdominal cavity.
Perforation
- rapid penetration through the wall, not enough to form adhesions
- into the free peritoneal cavity or into the covered space formed by adhesions
- 15% occur without previous ulcer problems
- severe pain - sudden, cruel, constant, uncontrollable
- picture of acute abdomen (acute peritonitis), shock
- X-ray native: free gas under the diaphragm
- leukocytosis with leftward shift
- Th: surgery
contraindication: X-ray using barium slurry
Pyloric stenosis
- rarely in duodenal or pyloric ulcers
- based on edema or fibrosis
- feeling of fullness, vomiting of older contents, 1-3 times a day, large volume
- exclude carcinoma (differential diagnosis)
Links[edit | edit source]
Related articles[edit | edit source]
References[edit | edit source]
- ↑ ČEŠKA, Richard. Interna. 1. edition. Praha : Triton, 2010. 855 pp. ISBN 978-80-7387-423-0.
