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Radiography in Perforated peptic ulcer

Ryo Tanaka, Shin-Ichi Kosugi, Daisuke Sato, Hiroshi Hirukawa, Tetsuya Tada, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Takashi Kobayashi, Toshifumi Wakai
We report a case of esophageal perforation (Boerhaave syndrome) caused by vomiting related to a duodenal ulcer with pyloric stenosis. A 45-year-old male presented with left chest pain and dyspnea after forceful vomiting. Chest radiography and computed tomography (CT) revealed a massive left pleural effusion and left tension pneumothorax. Abdominal CT revealed pyloric stenosis with a remarkably dilated stomach. Tube thoracostomy and nasogastric suction were immediately performed and we selected conservative treatment based on the following factors-a stable general condition without sepsis, early diagnosis, and good drainage...
August 2014: Clinical Journal of Gastroenterology
Bárbara Lobão
No abstract text is available yet for this article.
2013: BMJ Case Reports
Se-Jin Baek, Jin Kim, Sung-Ho Lee
Here, we present the case of a 53-year-old man with a hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation. On admission, the patient complained of severe acute abdominal pain, with physical examination findings suspicious for a perforated peptic ulcer. Of note, the patient had no history of other medical conditions or recent trauma, and the initial chest radiography and laboratory findings were not specific. A subsequent abdominal computed tomography revealed intrathoracic displacement of the liver, gallbladder, transverse colon and omentum through a right diaphragmatic defect...
October 21, 2012: World Journal of Gastroenterology: WJG
Z Z Sanogo, M Camara, M M Doumbia, L Soumaré, S Koumaré, S Keïta, A K Koïta, M A Ouattara, S Togo, S Yéna, D Sangaré
AIMS: To determine the most frequent causes of the digestive perforations and to evaluate the surgical procedures, the morbidity and mortality. PATIENTS AND METHODS: It was about a retrospective descriptive study, over 5 year's period in a visceral service of CHU du Point G, Bamako. Were included in the study all the patients operated for digestive perforation and hospitalized in the service of surgery "A". Were not included in the study patient operated not presenting a digestive perforation...
2012: Le Mali Médical
Shepard Schwartz, Yair Edden, Boris Orkin, Matityahu Erlichman
A perforated peptic ulcer in a child is a rare entity. Severe abdominal pain in an ill-appearing child with a rigid abdomen and possibly with signs of shock is the typical presenting feature of this life-threatening complication of peptic ulcer disease. We present a case of a 14.5-year-old adolescent girl who developed abdominal and shoulder pain that resolved after 1 day. She was then completely well for 2 days until the abdominal and shoulder pain recurred. On examination, she appeared well, but in pain. A chest radiograph revealed a large pneumoperitoneum...
July 2012: Pediatric Emergency Care
E Lionetti, R Francavilla, M Ruggieri, V Di Stefano, M B Principi, L Pavone
Neurofibromatosis type 1 is an autosomal dominant neurocutaneous disorder with characteristic features of skin and central nervous system involvement. Gastrointestinal complications are rare, especially during childhood. In adults, only two cases of peptic ulcer have been reported in neurofibromatosis, both due to Zollinger-Ellison syndrome. Peptic ulcer disease (PUD) may be primary or secondary in nature and it may be life threatening in the acute phase due to the risk of perforation. A case of recurrent gastrointestinal hemorrhage in a child with systemic neurofibromatosis and primary ciliary dyskinesia (PCD) is presented...
October 2009: Minerva Pediatrica
Miguel Rivero Fernández, Juan Angel González Martín, Enrique Vázquez-Sequeiros
The applications of clips in current therapeutics are increasingly numerous. Endoscopic hemoclipping for acute nonvariceal bleeding is a highly effective and safe modality for hemostasis with initial hemostatic rates of between 85 and 98% and a rebleeding rate of approximately 5-10% both in patients with peptic ulcer bleeding and signs of endoscopic risk (Forrest Ia-IIb) and in bleeding secondary to submucosal lesions, diverticular bleeding, Mallory-Weiss tear, bleeding Dieulafoy's lesions, and postpolypectomy bleeding...
March 2010: Gastroenterología y Hepatología
Ming-Yuan Huang, Wen-Han Chang
No abstract text is available yet for this article.
July 2, 2009: New England Journal of Medicine
Ji Hyeon Ju, Jun-Ki Min, Chan-Kwon Jung, Soon Nam Oh, Seung-Ki Kwok, Kwi Young Kang, Kyung-Su Park, Hyuk-Jae Ko, Chong-Hyeon Yoon, Sung-Hwan Park, Chul-Soo Cho, Ho-Youn Kim
Lupus mesenteric vasculitis (LMV) is a unique clinical entity found in patients who present with gastrointestinal manifestations of systemic lupus erythematosus, and is the main cause of acute abdominal pain in these patients. LMV usually presents as acute abdominal pain with sudden onset, severe intensity and diffuse localization. Other causes of abdominal pain, such as acute gastroenteritis, peptic ulcers, acute pancreatitis, peritonitis, and other reasons for abdominal surgery should be ruled out. Prompt and accurate diagnosis of LMV is critical to ensure implementation of appropriate immunosuppressive therapy and avoidance of unnecessary surgical intervention...
May 2009: Nature Reviews. Rheumatology
G Ngom, M L Diouf, M Fall, I Konaté, A A Sankalé, M Diop, I Fall, M Ndoye
A perforation rarely reveals a primary duodenal ulcer. The occurring of digestive haemorrhage in post operative followings evokes spontaneously a stress ulcer. We report an observation of a child who presented on fourth day delay after operation an ulcer of the anterior duodenal bulbar face and a haemorrhage of the posterior bulbar face. A 7-year-old girl with no particular pathological antecedent was admitted for abdominal pain, bile vomiting and constipation evolving since 6 days. Clinical examination revealed a general state thickening, an infectious syndrome, a meteoric and general abdominal sensitivity...
2008: Dakar Médical
J A Ashindoitiang, A O Atoyebi, R A Arogundade
OBJECTIVE: The plain abdominal x-ray is still the first imaging modality in diagnosis of acute abdomen. The aim of this study was to find the value of plain abdominal x-ray in the management of abdominal emergencies seen in Lagos university teaching hospital. BACKGROUND: The accurate diagnosis of the cause of acute abdominal pain is one of the most challenging undertakings in emergency medicine. This is due to overlapping of clinical presentation and non-specific findings of physical and even laboratory data of the multifarious causes...
July 2008: Nigerian Quarterly Journal of Hospital Medicine
Muhammad Hanif Shiwani, Michael P Thornton
No abstract text is available yet for this article.
August 2008: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Man-Chin Hua, Man-Shan Kong, Ming-Wei Lai, Chih-Cheng Luo
BACKGROUND: Although the detection of pediatric peptic ulcer disease (PUD) has recently been increasing, perforated peptic ulcer (PPU) in children is rare. We report our experience with PPU in children. MATERIALS AND METHODS: The charts of children diagnosed with PPU at our hospital from January 1986 to June 2005 were reviewed. Data were obtained on demographics, coexisting clinical events, perforation sites, delay in surgery, operative findings and methods, and outcomes...
July 2007: Journal of Pediatric Gastroenterology and Nutrition
Adachi Yasuko
A 65-year-old woman, who had been taking non-steroidal anti-inflammatory drugs (NSAIDs), prednisolone and methotrexate for rheumatiod arthritis, was admitted to our hospital with a sudden onset of left-back and chest pain and breathlessness. A chest radiograph and computed tomography revealed a left-side pneumothorax and pleural effusion. Chest tube was inserted for drainage and the fluid was formed to contain food residuum. Contrast radiography demonstrated escape of soluble contrast medium into the left pleural space...
September 2006: Nihon Kokyūki Gakkai Zasshi, the Journal of the Japanese Respiratory Society
Hsiu-Po Wang, Wei-Chih Su
No abstract text is available yet for this article.
March 9, 2006: New England Journal of Medicine
A Furukawa, M Sakoda, M Yamasaki, N Kono, T Tanaka, N Nitta, S Kanasaki, K Imoto, M Takahashi, K Murata, T Sakamoto, T Tani
Gastrointestinal tract perforation is an emergent condition that requires prompt surgery. Diagnosis largely depends on imaging examinations, and correct diagnosis of the presence, level, and cause of perforation is essential for appropriate management and surgical planning. Plain radiography remains the first imaging study and may be followed by intraluminal contrast examination; however, the high clinical efficacy of computed tomographic examination in this field has been well recognized. The advent of spiral and multidetector-row computed tomographic scanners has enabled examination of the entire abdomen in a single breath-hold by using thin-slice sections that allow precise assessment of pathology in the alimentary tract...
September 2005: Abdominal Imaging
N Ozalp, B Zulfikaroglu, I Bilgic, M Koc
OBJECTIVE: To assess the risk factor that influence mortality from perforated peptic ulcer. DESIGN: Retrospective study. SETTING: Ankara Numune Teaching and Research Hospital, Ankara, Turkey. SUBJECTS: A total of 342 patients with perforated peptic ulcer disease were identified from April 1997 to January 2004. Data for the patients were extracted from the hospital records, operative notes and clinic charts. MAIN OUTCOME MEASURES: Age, sex, coexisting medical illness, use of non-steroidal anti-inflammatory drugs (NSAID) or steroids, preoperative shock, delay in treatment location of ulcer size, type of operation time, albumin concentration postoperative complications, postoperative hospitals stay and mortality results for all patients were obtained...
December 2004: East African Medical Journal
Jin Hyoung Kim, Ji Hoon Shin, Zhen-Hai Di, Gi Young Ko, Hyun-Ki Yoon, Kyu-Bo Sung, Ho-Young Song
Fluoroscopically guided balloon (15 or 20 mm in diameter) dilation was performed on eight patients with benign duodenal strictures caused by peptic ulcers (n = 6), Crohn's disease (n = 1), and postoperative adhesion (n = 1). The procedure was technically and clinically successful without complications in seven of the eight patients (88%). Duodenal perforation occurred immediately after 20-mm-diameter balloon dilation in one patient who underwent emergency surgery. During the mean follow-up of 30 months (range, 2-103 months), there was recurrence in two of the seven patients (29%) who then underwent surgery...
April 2005: Journal of Vascular and Interventional Radiology: JVIR
Kwok-Wan Yeung, Ming-Sung Chang, Chao-Peng Hsiao, Jee-Fu Huang
The purpose of this study is to review the computed tomography (CT) appearance of gastrointestinal tract (GI) perforation. Forty-two patients with 10 cases of proximal GI perforation and 32 cases of distal GI perforation were evaluated based on the CT findings of extraluminal air (which was subdivided into the CT-falciform ligament sign crossing the midline and scattered pockets of air), bowel wall thickening (>8 mm in gastroduodenal wall, >3 mm in the small bowel wall, >6 mm in the caliber of the appendix and >5 mm in the colonic wall), associated abscess formation, ascites and adjacent fat stranding...
September 2004: Clinical Imaging
Antonio Pinto, Mariano Scaglione, Sabrina Giovine, Stefania Romano, Francesco Lassandro, Roberto Grassi, Luigia Romano
PURPOSE: To compare the site of multislice spiral computed tomography (MSCT) signs of gastrointestinal perforation and the site of perforation at surgery in forty perforated patients. MATERIALS AND METHODS: Between January 1 and July 31, 2003, a total of 40 patients (23 men and 17 women) underwent surgery for gastrointestinal perforation. In all cases, plain radiography of the abdomen was integrated by MSCT with the following parameters: 0.5 seconds gantry rotation time, 2...
September 2004: La Radiologia Medica
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