peptic%20ulcer%20disease
PEPTIC ULCER DISEASE
Peptic ulcer disease is the presence of ulceration in the stomach and proximal duodenum commonly and in the lower esophagus, distal duodenum or jejunum infrequently. It is characterized by mucosal damage secondary to pepsin and gastric acid secretion.
It is the principal cause of upper gastrointestinal hemorrhage.
Appropriate therapy depends on the cause of peptic ulcer disease.

Surgical Intervention

  • Recommended in patients with more emergent complications (ie hemorrhage, perforation, gastric outlet obstruction), refractory disease and intractability, or rare causes of ulcer disease (eg gastrinoma, Zollinger-Ellison syndrome)
    • The most common indication for surgery is bleeding
    • Peritonitis is a surgical emergency that needs patient resuscitation, laparotomy and peritoneal toilet, or omental patch placement
  • Indications for elective peptic ulcer surgery include resection of ulcers suspected to be malignant, failure to heal despite maximal medical therapy, intolerance or noncompliance with medical regimen, and relapse while on maximal medical therapy
  • Options for duodenal ulcer may include truncal vagotomy, selective vagotomy, highly selective vagotomy, partial gastrectomy
  • Options for gastric ulcer may include partial gastrectomy with gastroduodenal or gastrojejunal anastomosis
  • Options to relieve chronic obstruction may include vagotomy and pyroplasty, antrectomy, or gastroenterostomy
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 6 days ago
Every-two-month injections of the long-acting cabotegravir + rilpivirine were noninferior to once-monthly injections for virologic suppression at 48 weeks in people living with HIV*, according to the ATLAS-2M** study presented at CROI 2020 — thus providing a potential option with more convenient dosing.
Stephen Padilla, 19 Mar 2020
The assumption that children are less vulnerable to the coronavirus disease 2019 (COVID-19) compared to adults is not quite true and may even be dangerous, suggests a recent study.
22 Mar 2020
Sustained use of lopinavir-combined regimen appears to confer benefits among patients with the novel coronavirus disease (COVID-19), with improvement possibly indicated by increasing eosinophils, suggests a recent study.
24 Mar 2020
COVID-19 is a novel disease, with no existing immunity. The virus can be transmitted from person to person, quickly and exponentially. Here’s what we can do to slow down the spread, if not contain the outbreak.