tailieunhanh - Báo cáo y học: "Synchronous perforation of a duodenal and gastric ulcer: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Synchronous perforation of a duodenal and gastric ulcer: a case report. | Karangelis et al. Journal of Medical Case Reports 2010 4 272 http content 4 1 272 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Synchronous perforation of a duodenal and gastric ulcer a case report 21 12 Dimos Karangelis Georgios I Tagarakis Christos Karathanos Konstantinos Bouliaris Andony J Baddour Anargyros Giaglaras1 Abstract Introduction Peritonitis due to peptic ulcer perforation is a surgical emergency with a high risk of mortality and morbidity. Case presentation We present a rare case of a 54-year-old Caucasian man who underwent an emergency laparotomy for peritonitis caused by perforation of two peptic ulcers. The first was located on the anterior wall of the duodenum and the second was posterior pre-pyloric close to the lesser curvature. Conclusion To the best of our knowledge this is only the second report in the medical literature of a simultaneous perforation of two peptic ulcers though rare every surgeon performing open or laparoscopic repair of a perforated peptic ulcer should be aware of the possibility of simultaneous perforation. Introduction Peptic ulcer disease PUD gastric and duodenal ulcers remains one of the most prevalent and costly gastrointestinal diseases 1 . The annual incidence of peptic ulcer ranges from to 2 . Internationally the frequency varies among countries but there are two major precipitating factors Helicobacter pylori infection and the consumption of non-steroidal anti-inflammatory drugs NSAIDs . Ulcer incidence increases with age for both duodenal ulcers DUs and gastric ulcers GUs and DUs 3 emerge two decades earlier than GUs particularly in men. Several factors predict increased risk with NSAIDs such as H. pylori infection advanced age comorbidities and adjunct therapy with drugs such as corticosteroids anticoagulants and bisphoshonates. Complications bleeding perforation obstruction can occur in patients with peptic ulcers of any etiology. Perforation occurs in .