Perforated Gastric Ulcers

McGee, Gregory S.; Sawyers, John L.

doi:10.1001/archsurg.1987.01400170061009

Cited by 29 publications

(8 citation statements)

References 12 publications

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“…Also, there was no significant difference in mortality rate between gastric or duodenal ulcer and in patients with or without previous ulcer history. Apparently, these findings were at variance with those from two other studies [13,24] reporting a higher mortality rate in gastric peptic ulcer than in duodenal peptic ulcer and in acute peptic ulcer than in chronic peptic ulcer. Such apparent discrepancies might be explained by the characteristics of patients included in the study, and/or by different age or different surgical procedures [16,18] .…”

Section: Discussioncontrasting

confidence: 78%

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Testini¹,

Portincasa

Piccinni

et al. 2003

WJG

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AIM:To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city. METHODS:One hundred and forty-nine consecutive patients (M:F ratio=110:39, mean age 52 yrs, range 16-95) with peptic ulcer disease were investigated for clinical history (including age, sex, previous history of peptic ulcer, associated diseases, delayed abdominal surgery, ulcer site, operation type, shock on admission, postoperative general complications, and intra-abdominal and/or wound infections), serum analyses and radiological findings. RESULTS:The overall mortality rate was 4.0 %. Among all factors, an age above 65 years, one or more associated diseases, delayed abdominal surgery, shock on admission, postoperative abdominal complications and/or wound infections, were significantly associated (χ 2

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Section: Discussioncontrasting

confidence: 78%

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Testini¹,

Portincasa

Piccinni

et al. 2003

WJG

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“…It is, however, sometimes believed that resection could be beneficial even in elderly people or patients in septic shock [7, 25, 26]. It has been noticed that in those cases septic and hemorrhagic complications in the postoperative period are less common than in patients submitted to the ulcer suture only [17, 27]. The risk of macroscopically not evident gastric cancer advocates additionally for emergency resection, which offers a chance of definite treatment [6, 7, 15, 28].…”

Section: Discussionmentioning

confidence: 99%

Perforated Gastric Ulcer

Wysocki

Biesiada²,

Beben³

et al. 2000

Dig Surg

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Background/Aims: Reports about perforated gastric ulcer are scarce and thus it is difficult to settle for a uniform model of operative management. The purpose of the study was to review our experience with perforated gastric ulcer and evaluate the results of gastric resection vs. oversewing of the perforation. Methods: Within 36 years 77 patients with peritonitis caused by histologically confirmed perforated gastric ulcer were operated. Furthermore, in another 7 microscopic examination revealed that perforation occurred within the gastric cancer. There were twice as many male as female patients. Results: Recently, the overall postoperative mortality (20.8%) tended to decrease markedly. 32 patients (mean age 49.9 years) were submitted to gastric resection and this procedure was associated with 2.9% mortality. All 3 subjects in whom vagotomy, pyloroplasty and wedge resection of the ulcer had been performed survived. In 40 patients (mean age 61.5 years) only a suture of the ulcer was performed. This procedure was associated with high mortality (1/3 of patients died). Selection criteria included poor general medical status, age, comorbidities, and substantial progression of the inflammatory process. Conclusion: Authors believe that emergency gastrectomy is a safe procedure; however, it might be performed without excessive operative risk in only half of the patients.

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“…4.2%; if 2. 40%; and if all 3 risk factors are present, the mortality will be 87% [22], These figures have been elicited for perforated duo denal ulcer, and it is also recognised that there is a generally worse outlook for patients with perforated gastric ulcers [38][39][40][41][42], Mortality rates of up to 28% have been reported in recent years, and particularly is the mortality high if definitive surgery is per formed on the elderly [2. 8, 32].…”

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confidence: 99%

Perforated Peptic Ulcer – The Changing Scene

Cocks¹

1992

Dig Dis

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There is a changing scene with perforated peptic ulcer. The older age of presentation, the increased association with non-steroidal anti-inflammatory drugs, associated increased debility, and resulting higher mortality in the elderly, are causing a rethink in management protocols. Whereas years ago most discussion was on whether urgent definitive surgery was the most effective therapy, nowadays there is a tendency to less invasive measures. A ‘deliberative’ approach, wherein not all patients require surgery, is detailed, and there may be an increasing role for laparoscopic perforation-sealing techniques in the remainder. Anti-secretory and anti-helicobacter drugs have an important role in post-operative care following lesser procedures than definitive surgery.

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Perforated Gastric Ulcers

Cited by 29 publications

References 12 publications

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

Perforated Gastric Ulcer

Perforated Peptic Ulcer – The Changing Scene

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