Peptic Ulcer Complications

Peptic ulcers are open sores include :
Gastric ulcers 
Esophageal ulcers 
Duodenal ulcers

Perforation
Bleeding
Penetration
Maliginization
Obstruction

1. Complications of peptic ulcer disease DONE BY : MUSTAFA KHALIL IBRAHIM TBILISI STATE MEDICAL UNIVERSITY 4 th year, 1 st semester, 2 nd group

2. Anatomy & physiology

3. Peptic ulcer Peptic ulcers are open sores include : Gastric ulcers   Esophageal ulcers   Duodenal ulcers

4. Morbidity The number of elective operations for peptic ulcer disease dropped more than 70% in the 1980s; 80% of these procedures were emergent operations

5. Causes H . pylori infections are now uncommon. ( NSAIDs ). Smoking, alcohol. Mental stress. Genetics. This is because these types of ulcers do not always cause obvious symptoms, so are left untreated . It is estimated that around 1 in 50 people with a NSAID-related stomach ulcer will develop a complication.

6. Symptoms of complicated pud sudden, sharp pain that doesn’t stop black or bloody stools bloody vomitus vomit that looks like coffee grounds

7. Complications of pud Perforation Bleeding Penetration Maliginization Obstruction

8. Peptic Ulcer Perforation  It affects around 1 in 350 people with a stomach ulcer. Annual incidence of ulcer perforation is 4 to 14 cases per 100,000 individuals  Pneumoperitoneum

9. Surgical Treatment of perforation

10. vagotomy

11. Bleeding from Peptic Ulcer Melena Tachycardia Hypotension Main possible reasons: Peptic ulcer; Gastritis; Portal hypertension Stops spontaneously in 75%. Reminder will require surgery or die;

12. Bleeding from Peptic Ulcer Peptic ulcer hemorrhage is on the order of 19 to 57 cases per 100,000 individuals Internal bleeding is the most common complication of stomach ulcers. Internal bleeding can occur when an ulcer develops at a site of a blood vessel. You are at an increased risk of bleeding if you: are on continued use of non-steroidal anti-inflammatory drugs (NSAIDs) are 60 years old or over

13. Penetration of Peptic Ulcer

14. Malignization of Peptic Ulcer

15. Gastroectomy

16. Obstruction by Peptic Ulcer Symptoms: Vomiting –  Usually right after eating, yellow or green. contains foods eaten more than 12 hours earlier . Epigastric pain Constipation Loss of weight Hypokalemia and metabolic acidosis – Due to vomiting .  Hypertrophy of stomach muscles

17. Peptic ulcer Surgical Complications A. Early complications Duodenal stump leakage; Hemorrhage B. Late complications Recurrent ulcer Gastrojejunocolic and gastrocolic fistula Dumping syndrome (cardio-vascular and gastro-intestinal symptoms). Shortly after eating palpitations, sweating, weakness, flushing, nausea, vomiting, diarrhea etc. Anemia: iron deficiency anemia develops in 30% within 5 years after gastrectomy ; Postvagotomy diarrhea. Chronic gastroparesis

18. References http:// www.mayoclinic.org/diseases-conditions/peptic-ulcer/basics/treatment/con-20028643 Current Surgical Diagnosis and Treatment. A Lange Medical Book. 12th edition, Edited by G. Doherty and L. Way. 2006. pp:508-538 . https://www.google.ge/search?q=Penetration+of+Peptic+Ulcer&source=lnms&tbm=isch&sa=X&ved=0ahUKEwim75eNmbrNAhWCjywKHYG9AKsQ_AUICCgB&biw=1366&bih=599#tbm=isch&q=peptic+ulcer+& imgdii=Zs1jluqdcC6e6M%3A%3BZs1jluqdcC6e6M%3A%3BkT0uGJniXot5TM%3A&imgrc=Zs1jluqdcC6e6M%3A

19. Lansoprazole Amoxicillin Claritromycin H2 receptor antagonists Proton pump blockers Antacids