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JPMA. the Journal of the Pakistan... Jul 2023Duodenal ulcer perforation, a frequent surgical emergency, needs simple closure with indirect Graham's Omentopexy which is effective with excellent results in majority...
Duodenal ulcer perforation, a frequent surgical emergency, needs simple closure with indirect Graham's Omentopexy which is effective with excellent results in majority of cases despite patients' late presentation. The objective of the study was to determine the frequency of postoperative complications of perforated duodenal ulcer, conducted in the Surgery Department, Jinnah Postgraduate Medical Centre, Karachi, from March 20, 2018 to September 20, 2018. The study was a descriptive case series of 108 patients of both genders with perforated duodenal ulcer > 1 week old with ASA score I & II. Patients with trauma and comorbidities were excluded. The patients underwent laparotomy and peritoneal toilet, and after noting the site of perforation indirect Graham's Omentopexy was performed. Complications like duodenal fistula, peritonitis, and paralytic ileus, and patient's death within 10 days of surgery were noted. Age ranged from 18 to 50 years with mean age of 35.027±5.13 years, mean weight 71.120±12.77 kg, mean height 1.541 ±0.09 metres, mean BMI 29.975±4.99 kg/m2, and the mean duration of complaint was 4.194±1.30 weeks. Male predominance in 75 (69.4%) patients. Duodenal fistula was seen in 10 (9.3%) patients, peritonitis 12 (11.1%), paralytic ileus 14 (13%) and mortality was in 11 (10.2%) patients.
Topics: Humans; Male; Female; Adult; Infant; Duodenal Ulcer; Risk Factors; Peptic Ulcer Perforation; Peritonitis; Fistula
PubMed: 37469068
DOI: 10.47391/JPMA.4768 -
The Journal of the Association of... Aug 2023In the last 3 decades, omeprazole has proved its mettle in managing acid peptic diseases (APDs). It has established itself as the first line of therapy for duodenal and... (Review)
Review
BACKGROUND
In the last 3 decades, omeprazole has proved its mettle in managing acid peptic diseases (APDs). It has established itself as the first line of therapy for duodenal and gastric ulcers, gastroesophageal reflux disease (GERD), ulcers due to nonsteroidal anti-inflammatory drugs (NSAID), and Zollinger-Ellison syndrome (ZES).
OBJECTIVES
The purpose of this literature review is to assess the effectiveness of omeprazole as compared to the other proton pump inhibitors (PPIs) currently in use and its safety and efficacy in special populations, including the pediatric and geriatric populations.
RESULTS
Omeprazole was found to be the most effective PPI in the management of APDs due to its rapid action, good antioxidant effects, and effectiveness against nocturnal acid breakthroughs. Its safety and tolerance have been proved in various randomized controlled trials.
CONCLUSION
Omeprazole is the prototypical drug in the management of APDs and has withstood the test of time. After 3 decades, omeprazole remains the drug of choice in managing APD.
Topics: Humans; Child; Aged; Omeprazole; Proton Pump Inhibitors; Gastroesophageal Reflux; Stomach Ulcer; Anti-Inflammatory Agents, Non-Steroidal
PubMed: 37651247
DOI: 10.59556/japi.71.0322 -
The Surgical Clinics of North America Dec 2023Gastric and small bowel emergencies are often seen in the emergency department and require rapid assessment and intervention as patients can deteriorate quickly. Some of... (Review)
Review
Gastric and small bowel emergencies are often seen in the emergency department and require rapid assessment and intervention as patients can deteriorate quickly. Some of the more frequently seen gastric emergencies include gastric volvulus and peptic ulcer disease, which can present with ischemia, strangulation, perforation, or severe bleeding. Swift diagnosis is crucial to ensuring the proper management whether that is endoscopic or with surgical exploration. Perforated peptic ulcers that are not contained will require surgical intervention, whereas bleeding ulcers can often be controlled with endoscopic interventions.
Topics: Humans; Duodenal Ulcer; Emergencies; Peptic Ulcer Perforation; Intestine, Small
PubMed: 37838458
DOI: 10.1016/j.suc.2023.05.012