Document Detail


Perforated peptic ulcer following gastric bypass for obesity.
MedLine Citation:
PMID:  10075296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Peptic ulcer in the excluded segment of a gastric bypass performed in the management of morbid obesity has only rarely been reported in the literature. The purpose of this study is to review our experience with the condition in a series of 4300 patients who underwent gastric-restrictive surgery between 1978 and 1997. Eleven patients presented with acute perforation of a peptic ulcer in the excluded gastric segment. Nine ulcers were duodenal, one was gastric, and one patient had both gastric and duodenal perforations. The time between primary gastric-restrictive surgery and ulcer perforation varied from 20 days to 12 years. All patients presented with upper abdominal pain. The classical radiological sign of perforated peptic ulcer, free air under the diaphragm, did not occur in any patient. Nine patients were initially treated by primary closure of the perforation with subsequent definitive ulcer therapy by vagotomy, pyloroplasty, or gastrectomy. One case, initially treated elsewhere, was managed by placement of a Malecot catheter through the duodenal perforation, gastrostomy, and peritoneal drainage. One recent case remains symptom-free on H2 blockers after simple closure. There was no mortality. Six cases were previously reported in the literature with a 33 per cent mortality rate.
Authors:
A M Macgregor; N E Pickens; E K Thoburn
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American surgeon     Volume:  65     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-04-13     Completed Date:  1999-04-13     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  222-5     Citation Subset:  IM    
Affiliation:
North Florida Regional Medical Center, Gainesville, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Gastric Bypass / adverse effects*
Humans
Male
Middle Aged
Peptic Ulcer Perforation / etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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