Perforated duodenal ulcers after Roux-Y Gastric Bypass.

Pohl, Denise; Schmutz, Gregoire; Plitzko, Gabriel Andreas; Kröll, Dino; Nett, Philipp C.; Borbély, Yves Michael (2018). Perforated duodenal ulcers after Roux-Y Gastric Bypass. The American journal of emergency medicine, 36(8), 1525.e1-1525.e3. Elsevier 10.1016/j.ajem.2018.04.057

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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.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Pohl, Denise; Plitzko, Gabriel Andreas; Kröll, Dino; Nett, Philipp C. and Borbély, Yves Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1532-8171

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

10 Apr 2019 14:47

Last Modified:

10 Apr 2019 14:47

Publisher DOI:

10.1016/j.ajem.2018.04.057

PubMed ID:

29716802

Uncontrolled Keywords:

Duodenal ulcer Gastric bypass Morbid obesity Peptic ulcer perforation

BORIS DOI:

10.7892/boris.125791

URI:

https://boris.unibe.ch/id/eprint/125791

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