The Management of Perforated Peptic Ulcer

McKenna, K. P.

doi:10.1111/j.1445-2197.1968.tb03178.x

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…This was so in the past and it can surely be stated even more strongly since the advent of H2 receptor blockers. On the other hand, the great majority of patients who perforate a chronic ulcer will develop further symptoms [52,53], and if certain cri teria are fulfilled then PGV should be added to simple closure in these patients. The crite ria includes such things as the age of the patient, severe intercurrent disease, avail ability of surgical expertise, etc.…”

Section: Perforated Peptic Ulcermentioning

confidence: 99%

Surgery for Peptic Ulcer Disease in the Era of H<sub>2</sub> Receptor Blockers

Jamieson

1989

Dig Dis

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Section: Perforated Peptic Ulcermentioning

confidence: 99%

Surgery for Peptic Ulcer Disease in the Era of H<sub>2</sub> Receptor Blockers

Jamieson

1989

Dig Dis

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Should We Be Changing Our Operative Strategies for the Acute Complications of Peptic Ulcer Disease?

Jamieson

1988

Australian and New Zealand Journal of Surgery

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H2‐receptor blockade for the treatment of peptic ulcer disease has been with us for over a decade and has led to a dramatic decrease in the number of operations being performed for chronic ulcer disease. Many surgeons feel that the swing away from ulcer surgery has gone too far.1 Nevertheless surgeons may have been slow to grasp the importance of H2‐receptor blockers in the management of the acute complications of ulcer disease.

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Peptic ulcers: causes, prevention, perforation and treatment

Toosi¹

2016

IJBS

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Peptic ulcer disease (PUD) is a sore on the lining of stomach or duodenum. In some cases, a peptic ulcer may develop just above stomach in esophagus, i.e. esophageal ulcer. Peptic ulcer has always been the most common etiology underlying upper gastrointestinal perforation, while gastric perforation represents 10-15% of all peptic ulcers. Alternation in balance between aggressive and protective factors at the luminal surface of the epithelial cells, leads to development of peptic ulcer. Aggressive factors include Helicobacter pylori, hydrochloric acid, pepsins, nonsteroidal anti-inflammatory drugs (NSAIDs), bile acids, ischemia, hypoxia, smoking and alcohol. On the other hands, bicarbonate, mucus layer, mucosal blood flow, prostaglandins (PGs) and growth factors are the most known defensive factors. The shared symptoms include a dull or burning pain in middle or upper stomach between meals or at night, bloating, heartburn, nausea and vomiting are among the most common symptom of peptic ulcer. Some other symptoms in severe cases are dark or black stool (due to bleeding), vomiting blood, weight loss and pain in the mid to upper abdomen. An ulcer may or may not have all or some of the symptoms. In general, ulcers are best diagnosed by instrumental procedures depending on the case and the available facilities in the centre. The most reliable tests include, I) sophagogastroduodenoscopy (EGD), a thin tube with a camera inserted through the mouth into GIT. A biopsy is also taken during an EGD to be examined for H. pylori, II), X-ray for the upper GIT taken after drinking a thick barium salt, III) blood test to check if there is anemia and IV) detection of blood in the stool. Perforation is the major complication of PUD and the perforated peptic ulcer needs the use of surgical intervention. About 80% of the indications for peptic ulcer surgery are related to perforate peptic ulcers. Most cases are treated by simple suture of the perforated intestinal wall. In most cases, the best treatment is surgical or laparoscopic suture closure of the perforated ulcer. Natural products have found a special place in the treatment plans for peptic ulcer disease.Â They exhibit their antiulcerogenic activities by various mechanisms either prophylactic or therapeutic or both. The prophylactic products have considerable antioxidant and anti-inflammatory activities. On the other hand, therapeutic agents possess antisecretory or healing effects. The anti-H.pylori activity of some plant extracts, however, may explain their antiulcerogenic activity.

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The Management of Perforated Peptic Ulcer

Cited by 4 publications

References 10 publications

Surgery for Peptic Ulcer Disease in the Era of H<sub>2</sub> Receptor Blockers

Surgery for Peptic Ulcer Disease in the Era of H<sub>2</sub> Receptor Blockers

Should We Be Changing Our Operative Strategies for the Acute Complications of Peptic Ulcer Disease?

Peptic ulcers: causes, prevention, perforation and treatment

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