MyMedR

Perforated gastric ulcer in severe dengue infection: A case report

Ng CY, Lee SL, Foo SL

Med J Malaysia, 2017 08;72(4):244-245.

Abdominal pain is one of the common presentations in severe dengue infection. We report a rare case of perforated gastric ulcer in a young man diagnosed with severe dengue infection and the challenges we faced in managing this patient. Perforated gastric ulcer need to be considered if there are signs of peritonitis and persistent abdominal pain that does not conform to the natural history of dengue. Proper imaging and early surgical intervention in perforated gastric ulcer is vital in preventing further complication and reducing the risk of mortality.

Matched MeSH terms: Peptic Ulcer Perforation/etiology*; Peptic Ulcer Perforation/surgery; Peptic Ulcer Perforation/virology

Fulltext A man with an acute abdomen

Loh KY, Kew ST

Malays Fam Physician, 2008;3(2):109-10.

PMID: 25606131

Matched MeSH terms: Peptic Ulcer Perforation

Fulltext Perforated peptic ulcers in West Malaysia--a series of 73 cases treated by simple closure in a general hospital between 1972 and 1974

Said MY

Med J Malaysia, 1982 Sep;37(3):261-4.

PMID: 7177009

In a 3 year period 73 cases of perforated peptic ulcers were treated by simple closure. The overall mortality of 3.77 percent is acceptable when compared with other reports. There was a marked male preponderance (11 males: female 1). Biopsy results confirmed the operatiue findings that perforations were seven times more common in gastric peptic ulcers than duodenal ones. The disease affected young adults, the middle aged and elderly, the peak incidence occurring between the fifth and seventh decades oflife. Simple closure was an effective surgical procedure for our group of patients.

Matched MeSH terms: Peptic Ulcer Perforation/surgery*

Fulltext A case report on a 103 year old patient with perforated peptic ulcer

Tan SL

Med J Malaysia, 1980 Dec;35(2):162-3.

PMID: 7266411

A 103 year old patient was admitted with pain in the right iliac fossa. There was no response to conservative treatment. Subsequent laparatomy showed the presence of a perforated ulcer in the pyloric region. The condition improved gradually after the surgical management.

Matched MeSH terms: Peptic Ulcer Perforation/diagnosis*

Fulltext Fulminant necrotising amoebic colitis: A diagnostic conundrum

Michael A, Jasjit SN, Prabhu R

Med J Malaysia, 2015 Dec;70(6):365-6.

PMID: 26988213 MyJurnal

Fulminant necrotising amoebic colitis is a complication of untreated amoebiasis. This is seen in mainly low-income countries. It has a high mortality rate and is difficult to diagnose. We present an extremely rare case of fulminant necrotising amoebic colitis that caused diagnostic confusion in mimicking an acute abdomen, presumably caused by a perforated duodenal ulcer.

Matched MeSH terms: Peptic Ulcer Perforation

Remarks on the treatment of perforated duodenal ulcer

Black K

Malayan Medical Journal, 1927;2:13-5.

Matched MeSH terms: Peptic Ulcer Perforation

Comparison of features and outcomes of perforated peptic ulcer between Malaysians and foreigners

Kugan V, Mahadevan DT, Kandasami P

Med J Malaysia, 2016 02;71(1):12-6.

PMID: 27130737

BACKGROUND: Perforated peptic ulcers (PPU) present as serious surgical emergencies that carry high mortality and morbidity. Foreigners with PPU are also managed in our hospital setting. Their inclusion significantly alters the trend and pattern of PPU seen in Malaysia.

AIM: To compare per-operative and post-operative features and outcomes of perforated peptic ulcers between Malaysians and foreigners.

MATERIAL AND METHODS: This was an analytical crosssectional study. All patients who underwent repair of perforated peptic ulcer disease during a 6-year period were included. 50 consecutive patients' records with perforated peptic ulcer were analysed. Data were collected from operation theatre database and hospital medical records. Chi square and t test were performed using SPSS statistical software.

RESULTS: Total of 50 patients, of which 30 were Malaysians and 20 were foreigners. The mean age of Malaysian patients was 58.3 ± 15.2 years whereas the mean age for foreign patients was 30.3 ± 6.7 years, with foreign patients being significantly younger than local patients. Foreigners had significantly smaller ulcers with only 5% of them having ulcers more than 1cm while 36.7% of Malaysian patients had ulcers more than 1cm. Post-operative complications are significantly higher in Malaysian patients (p<0.05) with 40% of Malaysian patients and 10% of foreign patients developing post-operative complications.

CONCLUSION: Foreign patients are younger with significantly smaller perforated ulcers and better post-operative outcomes.

Matched MeSH terms: Peptic Ulcer Perforation/complications; Peptic Ulcer Perforation/surgery*

Definitive surgery for perforated peptic ulcer in Malaysia

Ti TK, Yong NK

Aust N Z J Surg, 1973 May;42(4):353-6.

PMID: 4532515

Matched MeSH terms: Peptic Ulcer Perforation/complications; Peptic Ulcer Perforation/mortality; Peptic Ulcer Perforation/epidemiology; Peptic Ulcer Perforation/surgery*

Fulltext Effect of H2 antagonists on outcome of simple closure for perforated duodenal ulcer

Koh KB, Chang KW

Singapore Med J, 1992 Oct;33(5):472-3.

PMID: 1360708

The treatment of perforated duodenal ulcer is controversial. Since the advent of H2 antagonists, the number of ulcer operations has declined tremendously. We wanted to find out if the addition of a H2 antagonist after simple closure of a perforated duodenal ulcer would change the outcome and therefore reviewed 46 patients treated in this fashion. Our results show that this is a safe and effective way of treating patients with perforated duodenal ulcer.

Matched MeSH terms: Peptic Ulcer Perforation/drug therapy*; Peptic Ulcer Perforation/surgery*

Laparoscopic repair of perforated peptic ulcers: the sutured omental patch and focused sequential lavage technique

Siow SL, Mahendran HA

Surg Laparosc Endosc Percutan Tech, 2014 Apr;24(2):134-9.

PMID: 24686348 DOI: 10.1097/SLE.0b013e31828fa951

We propose a standardized technique of repair and lavage with the outcomes of 50 consecutive patients treated at our institution. The perforation was closed primarily and reinforced with omental patch. It was then followed by peritoneal lavage in a focused sequential manner that involved quadrant to quadrant lavage with tilting of operating table and changing of position between the surgeon and the camera surgeon. None of our patients had postoperative intra-abdominal complications, but unfortunately 1 patient succumbed to respiratory complications. Respiratory complications was the most common postoperative complication in our series (9 patients), whereas 2 patients had ileus. There were no leaks or reoperations in our series. Laparoscopic repair and sutured omentoplasty, followed by focused sequential lavage in a systematic manner, if performed diligently, will yield good outcomes.

Matched MeSH terms: Peptic Ulcer Perforation/surgery*

Fulltext Adult Bochadalek hernia complicated with perforated gastric ulcer: preoperative diagnosis with multiplanar CT

Faizah MZ, Sharifah MI, Johoruddin K, Juliana AL

Med J Malaysia, 2011 Oct;66(4):367-8.

PMID: 22299562 MyJurnal

Matched MeSH terms: Peptic Ulcer Perforation/etiology*

Fulltext Perforated malignant gastric ulcer in a pregnant young adult: a case report

Jasmi AY, Normala B, al-Amin MD

Med J Malaysia, 2000 Mar;55(1):135-7.

PMID: 11072499

Gastric cancer in the young adult is rare and has been said to be more aggressive than gastric cancers of the older age group. Its unique association with pregnancy is even rarer. However, they have similar complications of haemorrhage, obstruction and perforation. We report a 27 year old lady at 16 weeks gestation who presented with a perforated malignant gastric ulcer and carcinomatosis peritonei. Reviewing the literature, we realised that such complication of a gastric cancer occurring in a pregnant young adult has not been previously documented.

Matched MeSH terms: Peptic Ulcer Perforation/complications*

Fulltext Laparoscopic versus open repair of perforated peptic ulcer: Improving outcomes utilizing a standardized technique

Siow SL, Mahendran HA, Wong CM, Hardin M, Luk TL

Asian J Surg, 2018 Mar;41(2):136-142.

PMID: 27955872 DOI: 10.1016/j.asjsur.2016.11.004

BACKGROUND/OBJECTIVE: The objective of this study was to compare the outcomes of patients who underwent laparoscopic and open repair of perforated peptic ulcers (PPUs) at our institution.

METHODS: This is a retrospective review of a prospectively collected database of patients who underwent emergency laparoscopic or open repair for PPU between December 2010 and February 2014.

RESULTS: A total of 131 patients underwent emergency repair for PPU (laparoscopic repair, n=63, 48.1% vs. open repair, n=68, 51.9%). There were no significant differences in baseline characteristics between both groups in terms of age (p=0.434), gender (p=0.305), body mass index (p=0.180), and presence of comorbidities (p=0.214). Both groups were also comparable in their American Society of Anesthesiologists (ASA) scores (p=0.769), Boey scores 0/1 (p=0.311), Mannheim Peritonitis Index > 27 (p=0.528), shock on admission (p<0.99), and the duration of symptoms > 24 hours (p=0.857). There was no significant difference in the operating time between the two groups (p=0.618). Overall, the laparoscopic group had fewer complications compared with the open group (14.3% vs. 36.8%, p=0.005). When reviewing specific complications, only the incidence of surgical site infection was statistically significant (laparoscopic 0.0% vs. open 13.2%, p=0.003). The other parameters were not statistically significant. The laparoscopic group did have a significantly shorter mean postoperative stay (p=0.008) and lower pain scores in the immediate postoperative period (p<0.05). Mortality was similar in both groups (open, 1.6% vs. laparoscopic, 2.9%, p < 0.99).

CONCLUSION: Laparoscopic repair resulted in reduced wound infection rates, shorter hospitalization, and reduced postoperative pain. Our single institution series and standardized technique demonstrated lower morbidity rates in the laparoscopic group.

Matched MeSH terms: Peptic Ulcer Perforation

Gastric acid secretion in duodenal ulcer disease in the Malaysia-Singapore region

Ti TK

Ann Acad Med Singap, 1983 Oct;12(4):507-17.

PMID: 6678134

Basal and pentagastrin stimulated acid output was measured in 80 normal and 179 duodenal ulcer subjects of Chinese, Indian and Malay origin. Basal and maximally stimulated acid output was significantly higher in duodenal ulcer patients compared with normal subjects. There was however considerable overlap and less than one in four duodenal ulcer patients were hypersecretors. The acid output (and hence the parietal cell mass) was lower than in Caucasian subjects and this was possibly related to weight differences. The acid output did not differ significantly in the Chinese, Indian and Malay subjects, suggesting that parietal cell mass in the three racial groups is closely similar. The difference in frequency of duodenal ulcer disease in the three racial groups is thus not related to gastric secretory capacity.

Matched MeSH terms: Peptic Ulcer Perforation/metabolism

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