peptic ulcer complications

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COMPLICATIONS OF PEPTIC ULCER DISEASE DONE BY : MUSTAFA KHALIL IBRAHIM TBILISI STATE MEDICAL UNIVERSITY 4 th year, 1 st semester, 2 nd group

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PET SCAN

Complications of peptic ulcer disease

DONE BY : MUSTAFA KHALIL IBRAHIMTBILISI STATE MEDICAL UNIVERSITY4th year, 1st semester, 2nd group

1

Anatomy & physiology

Peptic ulcerPeptic ulcers are open sores include : Gastric ulcersEsophageal ulcersDuodenal ulcers

Morbidity The number of elective operations for peptic ulcer disease dropped more than 70% in the 1980s; 80% of these procedures were emergent operations

Causes H. pylori infections are now uncommon.(NSAIDs).Smoking, alcohol.Mental stress.Genetics.

This is because these types of ulcers do not always cause obvious symptoms, so are left untreated.It is estimated that around 1 in 50 people with a NSAID-related stomach ulcer will develop a complication.

Symptoms of complicated pud sudden, sharp pain that doesnt stopblack or bloody stoolsbloody vomitusvomit that looks like coffee grounds

Complications of pud

PerforationBleedingPenetrationMaliginizationObstruction

Peptic Ulcer PerforationIt affects around 1 in 350 people with a stomach ulcer. Annual incidence of ulcer perforation is 4 to 14 cases per 100,000 individuals

Pneumoperitoneum

Surgical Treatment of perforation

vagotomy

Bleeding from Peptic Ulcer MelenaTachycardia Hypotension

Main possible reasons:Peptic ulcer;Gastritis;Portal hypertension

Stops spontaneously in 75%. Reminder will require surgery or die;

Bleeding from Peptic Ulcer

Peptic ulcer hemorrhage is on the order of 19 to 57 cases per 100,000 individuals Internal bleeding is the most common complication of stomach ulcers. Internal bleeding can occur when an ulcer develops at a site of a blood vessel. You are at an increased risk of bleeding if you:are on continued use of non-steroidal anti-inflammatory drugs (NSAIDs)are60 years old or over

Penetration of Peptic Ulcer

Malignization of Peptic Ulcer

Gastroectomy

Obstruction by Peptic Ulcer

Symptoms:Vomiting Usually right after eating, yellow or green. contains foods eaten more than 12 hours earlier.Epigastric pain Constipation Loss of weightHypokalemia and metabolic acidosis Due to vomiting.Hypertrophy of stomach muscles

Peptic ulcer Surgical ComplicationsA. Early complicationsDuodenal stump leakage;Hemorrhage

B. Late complicationsRecurrent ulcer Gastrojejunocolic and gastrocolic fistulaDumping syndrome (cardio-vascular and gastro-intestinal symptoms). Shortly after eating palpitations, sweating, weakness, flushing, nausea, vomiting, diarrhea etc.Anemia: iron deficiency anemia develops in 30% within 5 years after gastrectomy;Postvagotomy diarrhea. Chronic gastroparesis

References http://www.mayoclinic.org/diseases-conditions/peptic-ulcer/basics/treatment/con-20028643Current Surgical Diagnosis and Treatment. A Lange Medical Book. 12th edition, Edited by G. Doherty and L. Way. 2006. pp:508-538.https://www.google.ge/search?q=Penetration+of+Peptic+Ulcer&source=lnms&tbm=isch&sa=X&ved=0ahUKEwim75eNmbrNAhWCjywKHYG9AKsQ_AUICCgB&biw=1366&bih=599#tbm=isch&q=peptic+ulcer+&imgdii=Zs1jluqdcC6e6M%3A%3BZs1jluqdcC6e6M%3A%3BkT0uGJniXot5TM%3A&imgrc=Zs1jluqdcC6e6M%3A

LansoprazoleAmoxicillinClaritromycin

H2 receptor antagonists Proton pump blockersAntacids