Conservative management of perforated peptic ulcers
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Conservative management of perforated peptic ulcers involves non-operative treatment and close clinical monitoring. It has historically had high mortality rates of around 11% but more recent studies using gastrograffin contrast studies have found lower releak rates of around 2%. Candidates for conservative management are those with sealed perforations identified on contrast studies. The treatment involves bowel rest, broad-spectrum antibiotics, proton pump inhibitors, and observation for signs of reperforation over 6-12 hours. Conservative management provides an alternative to surgery with lower operative mortality risks for carefully selected patients.
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Hiatal hernia
Synonyms Hiatus hernia
Hiatalhernia.gif
A drawing of a hiatal hernia
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Risk factors Obesity, older age, major trauma[1]
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[edit on Wikidata]
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Peptic ulcer treatment
This document discusses the pharmacotherapy of peptic ulcers. It begins by classifying the main drugs used: 1) those that inhibit gastric acid secretion like H2 blockers and proton pump inhibitors, 2) antacids that neutralize acid, 3) ulcer protectives like sucralfate, and 4) anti-H. pylori drugs for eradication. It then goes into detail about the mechanisms, uses, and side effects of the major drug classes. H2 blockers competitively block H2 receptors to suppress acid secretion. Proton pump inhibitors irreversibly inactivate the H+/K+ ATPase pump for prolonged acid inhibition. Antacids chemically neutralize acid. Sucralfate
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Presentation of Italy
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Presentation on Italy
Italy is located in southern Europe, bordering France, Austria, Slovenia and Switzerland. Rome is the capital city. The boot-shaped Italian peninsula stretches over 1000 km from north to south and includes the major islands of Sicily and Sardinia. Italy has a predominantly Mediterranean climate. Roman Catholicism is the dominant religion. The official language is Italian, though regional dialects vary widely. Politically, Italy is a republic with a president as head of state and a bicameral parliament. Its economy ranks as the 6th largest globally and relies on industries like automobiles, shipbuilding and food processing.
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Peptic Ulcer Complications
Peptic ulcers are open sores include :
Gastric ulcers
Esophageal ulcers
Duodenal ulcers
Perforation
Bleeding
Penetration
Maliginization
Obstruction
Management of peptic ulcer disease
The document outlines the treatment and management of peptic ulcer disease. For H. pylori-positive patients, it recommends triple therapy with a proton pump inhibitor, clarithromycin, and metronidazole or amoxicillin for 14 days. For H. pylori-negative patients, it recommends treatment with proton pump inhibitors or H2 receptor antagonists along with antacids. It describes surgical interventions for complications or treatment failure and recommends lifestyle changes and prophylactic treatment for high-risk patients to prevent ulcers.
BREAST CANCER
- Breast cancer is a condition where breast cells grow uncontrollably and can spread to other parts of the body. It has various stages from non-invasive to invasive metastatic cancer.
- Current treatments include surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy, but these have side effects. New treatments are being researched to provide minimum side effects, costs and maximum survival and quality of life.
- Successful new treatments would improve outcomes for individuals, families and society through increased survival rates, decreased costs and improved psychology and life quality.
Surgical treatment for peptic ulcer disease
This document discusses surgical treatments for peptic ulcer disease. It outlines relevant anatomy and physiology, classifications of PUD, indications for surgery, and various surgical options including vagotomy, gastrectomy, Graham's omental patch, and suture ligation of the gastroduodenal artery. Complications are also reviewed. The prognosis is generally satisfactory with operative procedures, though complications can include bleeding, leakage, obstruction, and recurrent ulceration. Delayed treatment increases morbidity and mortality risks.
Omentum – anatomy, pathological conditions and surgical importance
The omentum is a fold of tissue that hangs down from the stomach and extends over other abdominal organs. It has important functions like immunity, absorbing edema, and limiting spread of infection. The greater omentum develops from the dorsal mesogastrium and extends from the stomach to the transverse colon. The lesser omentum connects the stomach and duodenum to the liver. Pathologies of the omentum include cysts, torsion, and tumors. Clinically, the omentum helps drain collections, access the retroperitoneum surgically, and forms adhesions useful for patching perforations.
Pep ulcer
Peptic ulcers form in the stomach or duodenum due to an imbalance between acid secretions and mucosal defenses. Risk factors include H. pylori infection in 90% of cases, NSAID use, and stress. Complications include hemorrhage, perforation, and obstruction. H. pylori survives stomach acid through urease production. Diagnosis involves symptoms and imaging. Treatment depends on complications but usually involves antibiotics to eradicate H. pylori along with acid suppression. Surgery may be needed for perforation or obstruction.
Perforated Peptic Ulcer Discussion
The document discusses perforated peptic ulcer disease. It describes a case of a 74-year-old Malay woman who presented with signs of peritonitis and anemia and was found to have a perforated duodenal ulcer during emergency surgery. It then provides background information on peptic ulcers and their causes, notably H. pylori infection and NSAID use. Treatment approaches for perforated ulcers are discussed, including conservative management, suture repair, and increasingly laparoscopic surgery. Post-operative outcomes can be influenced by factors like patient characteristics and complications.
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Computer network
A computer network allows devices to exchange data through connections between nodes. Nodes originate, route, and terminate data and can include devices like computers, phones, and servers. Networks differ in transmission media, communication protocols, and size. They facilitate interpersonal communication and sharing of files and resources. Most network data is carried in packets that are assembled after reaching their destination. Network topology diagrams depict logical connections rather than physical layout.
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This document provides an overview of peptic ulcers, including:
1. It defines peptic ulcers as erosions of the GI mucosa caused by digestive acids, most commonly occurring in the stomach and duodenum.
2. The pathophysiology of peptic ulcers is described as an imbalance between aggressive factors like acid and pepsin and protective mechanisms of the mucosa.
3. Treatment options for peptic ulcers include medications to reduce acid secretion, eradicate H. pylori infections, and surgery for complicated cases. Goals of treatment are to heal ulcers and prevent recurrence through lifestyle changes.
Peptic ulcers.pptx
This document provides an overview of peptic ulcers, including:
1. It defines peptic ulcers as erosions of the GI mucosa caused by digestive acids, most commonly occurring in the stomach and duodenum.
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11 stomach and duodenum
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1. Peptic ulcers are erosions in the gastric or duodenal mucosa that are caused by an imbalance between defensive and damaging factors like H. pylori infection, NSAIDs, and smoking.
2. H. pylori infection and NSAID use are the most common causes of peptic ulcers, as they compromise the mucosal defense system through various mechanisms like toxin production, inflammation, and decreased prostaglandin levels.
3. Duodenal ulcers are more common than gastric ulcers and are often associated with increased acid secretion, while gastric ulcers can form with normal acid levels due to damage to the mucus barrier.
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Hpylori2020new
This document discusses Helicobacter pylori (H. pylori), including its epidemiology, complications, diagnosis, and treatment. Some key points:
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Conservative management of perforated peptic ulcers
- 1. Conservative management of perforated peptic ulcers Zeeshan Rahman
- 2. Peptic ulcer disease • Most prevalent disease of the gastrointestinal tract. • Incidence: 0.1 – 0.3 % in western countries. • Major precipitating factors: 1.Helicobacter pylori infection 2.NSAID drug abuse
- 3. Epidemiology • Decreasing incidence of peptic ulcer disease - Discovery of PPI/H2 antagonist - Discovery of H.pylori
- 4. • In 2005 Barry J. Marshal and J. Robin Warren discovered the role of H. pylori in peptic ulcer
- 5. PUD • Considered a derangement in the mucosal function of the stomach and duodenum
- 6. Complications • Bleeding • Perforation • Obstruction
- 7. Perforation • Incidence : 5 – 10% in patients with active ulcer disease • Duodenal perforation: 60% • Antral perforation: 20% • Gastric perforation: 20%
- 8. Taylor (20th century) • Study on non-operative management of peptic ulcer. • 256 patients treated non-operatively for peptic ulcer disease. • 21 needed surgical intervention • Overall mortality rate was 11% • Usual operative mortality rate – 22%
- 9. Reason for poor acceptance • Need for close clinical monitoring of patients 6-12 hours after perforation : Stage of delusion - Acute pain of peritonitis subsides - Abdominal rigidity lessens - Leakage of enteric contents continue
- 10. Types of peptic ulcer perforations
- 11. When to decide to offer conservative management • Sealed perforations • Water soluble contrast medium- Gastrograffin study used • 40% of patients examined – No releak • Incidence of releak – 2 in 109 patients
- 13. Conservative management of perforated peptic ulcers