Perforated duodenal ulcers after Roux-Y Gastric Bypass
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Perforated duodenal ulcers after Roux-Y Gastric Bypass. / Pohl, Denise; Schmutz, Gregoire; Plitzko, Gabriel; Kröll, Dino; Nett, Philipp; Borbély, Yves.
In: AM J EMERG MED, Vol. 36, No. 8, 08.2018, p. 1525.e1-1525.e3.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Perforated duodenal ulcers after Roux-Y Gastric Bypass
AU - Pohl, Denise
AU - Schmutz, Gregoire
AU - Plitzko, Gabriel
AU - Kröll, Dino
AU - Nett, Philipp
AU - Borbély, Yves
N1 - Copyright © 2018 Elsevier Inc. All rights reserved.
PY - 2018/8
Y1 - 2018/8
N2 - Even though the incidence of complicated peptic ulcer disease (PUD) has decreased in the last decades, it remains a condition with a significant mortality. Whilst diagnosis and treatment of PUD in morbidly obese patients can be challenging, patients with excluded segments - such as after Roux-Y Gastric Bypass (RYGB) - present an even greater problem, as the subsequent altered anatomy impedes the common modalities used for diagnostic and therapeutic measures. We report the cases of two patients after RYGB with perforated duodenal ulcers in the intention to highlight problems regarding diagnosis and treatment. Patients with perforation after RYGB usually present without signs of hollow organ perforation in clinical examination but also in computed tomography scans. Diagnostic laparoscopy was performed to address the discrepancy between pain and non-diagnostic examinations. An aggressive approach in case of unexplained symptoms in these patients is not only justified but mandatory.
AB - Even though the incidence of complicated peptic ulcer disease (PUD) has decreased in the last decades, it remains a condition with a significant mortality. Whilst diagnosis and treatment of PUD in morbidly obese patients can be challenging, patients with excluded segments - such as after Roux-Y Gastric Bypass (RYGB) - present an even greater problem, as the subsequent altered anatomy impedes the common modalities used for diagnostic and therapeutic measures. We report the cases of two patients after RYGB with perforated duodenal ulcers in the intention to highlight problems regarding diagnosis and treatment. Patients with perforation after RYGB usually present without signs of hollow organ perforation in clinical examination but also in computed tomography scans. Diagnostic laparoscopy was performed to address the discrepancy between pain and non-diagnostic examinations. An aggressive approach in case of unexplained symptoms in these patients is not only justified but mandatory.
KW - Aged
KW - Duodenal Ulcer/complications
KW - Female
KW - Gastric Bypass/adverse effects
KW - Humans
KW - Laparoscopy
KW - Middle Aged
KW - Obesity, Morbid/surgery
KW - Peptic Ulcer Perforation/diagnostic imaging
KW - Postoperative Complications/diagnostic imaging
KW - Reoperation
KW - Tomography, X-Ray Computed
U2 - 10.1016/j.ajem.2018.04.057
DO - 10.1016/j.ajem.2018.04.057
M3 - SCORING: Journal article
C2 - 29716802
VL - 36
SP - 1525.e1-1525.e3
JO - AM J EMERG MED
JF - AM J EMERG MED
SN - 0735-6757
IS - 8
ER -