ABSTRACT
Objective: As the peptic ulcer affects 2-10% of the population and is gradually affecting more of the young as compared to the old so a study was designed to identify the factors associated and look for the complications and incidence of peptic ulcer perforation in young adults. Methods: Patients of either sex between 18-30 years of age diagnosed of peptic ulcer perforation (gastric or duodenal ulcer perforation) failing to respond to medical therapy, admitted on an emergency basis were included into the study. Intra-operative findings pertaining to exploration under general anesthesia, release of free gas as the abdomen was opened, site and size of perforation, amount and nature of peritoneal contamination present were made note
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(1-3)
The disease demands prompt diagnosis, timely resuscitation and proper surgical management so as to reduce the morbidity and mortality. Surgery is the mainstay of emergency treatment of these life-threatening complications that are refractory to medical management. The ideal treatment for the perforation of duodenal ulcer has not yet been established. (4-5)
Duodenal perforation is a very common and fatal complication in patients of chronic peptic ulcer symptoms with inadequate or no medical treatment. Perforated duodenal ulcer is mainly a disease of young men but owing to increased smoking and drinking habits in women, NSAID abuse in all the age groups and work related stress, from past few decades peptic ulcer is commonly reported in all adult young population. Up to 80% of patients with perforated duodenal ulcers are Helicobacter pylori positive.
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DISCUSSION
Peptic ulcer perforation is the commonest perforation of the gastrointestinal tract that demands prompt diagnosis, timely resuscitation and proper surgical management so as to reduce the morbidity and mortality. Surgery is the mainstay of emergency treatment.
In a study conducted by Bharti et al (1996) on peptic ulcer perforation, group of patients falling between 31-40 years of age had a maximum incidence of peptic ulcer perforation i.e. 48%. Of these, 72% patients had duodenal perforation. 84% patients had a positive X-ray finding and 94% were positive on ultrasound examination (1).
Hannan et al (2005) in their study of peptic perforation also reported highest incidence of 34% in the age group of 30-40 years. The mean age of the patients was 41 years (2).
Duodenal perforation is a very common and fatal complication in patients of chronic peptic ulcer symptoms with inadequate or no medical treatment.
Different from the above two studies, Elnagib et al (2008) reported the maximum incidence of peptic ulcer perforation i.e. 38% in still younger patients of age group of 20-30 years. NSAIDs abuse is amongst an important causative factor for perforation accounting for a total of 43% patients with stress and alcoholism together accounting for 23%
CSI-1 Conclusion A young male adult was cut in the left hypochondriac region with a knife pointed upward, which was previously used for cutting ribs. The patient is experiencing pain in the thoracic area and he is also suffering pain in the abdominal region which is the location of the knife wound. He is also suffering from respiratory issues deep within the thoracic area. Additionally, the patient shows redness and swelling in the pelvic region.
This time with stomach pains, diarrhea, and bloating. Viewing the bacteria in their gut during week 7, there is a new type of bacteria called C. difficile. This bacteria can cause deadly infections. It was developed in this persons gut becuase of all the empty space. It invaded it's way into their gut and rapidly started to multiply.
Often we find belly fat but sometimes intestines can pass through the opening. Small hernias (non-reducible), where the contents cannot be put back through the abdominal wall, by pressure under the skin or navel. These seldom cause problems and can often be left alone. It is however recommended that it be checked regularly to ensure the texture, size and color have not changes.
Fifteen year old Lewis Blackman died after a minimally invasive surgery. The cause of death was due to perforated bowel caused by ketorolac, a highly potent non-steroidal anti-inflammatory to treat pain and inflammation and for its potential for stomach ulceration. As I read the case, I noticed the following system failures that lead to this sentinel event. First, ketorolac has a black box warning “not to be used in pediatric patients.” 1 A black box warning is the strictest warning put in the labeling of prescription drugs by the Food and Drug Administration when there is reasonable evidence of an association of a serious hazard with the drug.
In Jay Hardy article, “Medical Wisdom Challenged by a Cocktail” analyzes the discovery of the real cause of gastric ulcers. Also, he talked about Marshall’s struggle trying to prove his theory in an outrageous way. Most scientists thought the cause of stomach ulcers before Warren and Marshall’s discovery were stress, excess acid, and eating spicy food. However, German scientists researched that a spiral-shaped bacterium inhabited that was lining of the human stomach, but they couldn’t culture the organism. So, the research on stomach ulcers were forgotten.
Crohn and his two co-workers, Oppenheimer and Ginzburg, presented a paper on “Terminal Ileitis”, and it was described in the features of Crohn’s disease to the JAMA. It was published later that year as a landmark article in the Journal of the American Medical Association aka “JAMA” and with the title “Regional Ileitis: A Pathologic and Chronic Entity.” The JAMA article was published at a time
:- Distribution- Crohn’s disease affects the smaller as well as larger bowel whereas ulcerative affects only
West End Villa nursing home of the Extendicare chain in Ottawa recently had one of its residents, eighty-nine-year old Luba Ignatieva, sent to the hospital following a detection of maggots in a wound. Following the unsightly discovery by staff at the nursing home, Luba was treated at a hospital, concerning her family and the police. This prompted an investigation further into the case by the elder-abuse unit; however, according to the Ottawa force 's official statement it was regarded as a non-criminal matter. Chronic “venous stasis ulcer” is what Luba has on her leg and needs to be checked on and treated twice a week by a worker at the nursing home. According to Luba, only one out of two scheduled dressing changes took place, thus resulting
According to the Mayo Clinic staff (2014), chronic inflammation can create ulcers in the digestive system, located anywhere from the mouth to the anus, and also the genital area. Inflammation to the lining of the stomach, can lead to scars that can spread throughout the bowel wall completely. Mayo Clinic Staff (2014) state that Crohn’s causes the intestinal wall to become thickened as time goes by, which prevents food from digesting properly due to blockage making it hard for stools to pass by. Mucosa is what protects the stomach, by having Crohn’s, excess mucous is being produced which can make an individual feel as if they are always needing to go to the bathroom.
My maternal grandmother and I both suffer from intestinal illnesses but my family doctor said her having (GERD) which is a digestive disorder caused by acid reflux didn’t make me more likely to get or caused me to get Gastritis. My grandmother has received treatment and changed her diet to help her manage her symptoms. To help with my gastritis I have also changed my diet and take a medication when needed for certain
When I was first diagnosed with ulcerative colitis, a common colon disease, I had no idea what it was. It wasn’t until several tests and explanations from multiple doctors that my parents and I started to understand the extent of the problem. Although it didn’t seem like it would be a big deal, it quickly took over my entire life. Dealing with the condition meant chronic pain, medication, and many more doctors’ visits. Fortunately, my case wasn’t too severe.
Depending on where the inflammation occurs within the large intestine UC is classified by how far the disease extends up the colon. Research has shown that genes, the environment, and an overactive immune response could play a role in causing UC unfortunately, the exact cause of the disease is not known. “Research sponsored by CCFA has led many scientists to believe that ulcerative colitis may be the result of an interaction of a virus or bacterial infection of the colon and your body’s natural immune system response”(Crohn’s & Colitis Foundation of America, 2015). Although research has not be able to pinpoint the exact cause of Ulcerative Colitis it can actually occur in people of any age. Nonetheless, research has shown that it hoes have a higher occurrence rate in people between the ages of 15 and 30, who have family members with Inflammatory Bowel Disease, and who are of Jewish
Today, the laparoscopic procedure is more common for those who qualify. This method is performed by making up to five small incisions in the outer stomach wall and using extremely small instruments and a tiny camera to guide
When he was touring Kyushu, he suffered from severe periostitis from these chronic cavities and he had to be admitted to the Kyushu University Hospital for major surgery. He returned home after the surgery, but his post operative condition wasn’t good and he didn’t know
At least 70 million people in the U.S. suffer from some sort of digestive illness (not including heartburn), and digestive problems account for nearly 10% of all healthcare spending. The hard-working gut allows nutrients and water to enter the body while preventing the entry of toxins/antigens. It’s a selective barrier between “us” and the outside world. But a distressed gut can’t act in our defense.