Conservative Management of Asymptomatic Pneumoperitoneum; Report of Two Cases
Archives of Academic Emergency Medicine,
Vol. 7 No. 1 (2019),
1 Dey 2019
,
Page e12
https://doi.org/10.22037/aaem.v7i1.166
Abstract
Peptic ulcer disease is a common gastrointestinal disorder has been reduced in recent years due to effective new treatments. Peptic ulcer perforation is an emergent life-threatening condition causes pneumoperitoneum and septic shock. It often requires surgical procedures. We describe two cases of peptic ulcer perforation with only mild discomfort on the epigastric region since several months ago. The patients treated with high dose proton pump inhibitor and conservative actions without surgical procedures. Weekly follow up the cases showed that the clinical condition of patients remains stable without any new signs and symptoms. This report showed noninvasive treatment can be effective alone, in some cases with mild symptoms.
- Peptic Ulcer Perforation
- Pneumoperitoneum
- Proton Pump Inhibitors
- Conservative Treatment
How to Cite
References
Zelickson MS, Bronder CM, Johnson BL, et al. Helicobacter pylori is not the predominant etiology for peptic ulcers requiring operation. The American Surgeon. 2011;77(8):1054-60.
Avila Alvarez AA, Parra JF, Buitrago DA, Rodriguez F, Moreno A. Gastric Perforation and Phlegmon Formation by Foreign BodyIngestion. Emerg (Tehran). 2014;2(3):141-3.
Suriya C, Kasatpibal N, Kunaviktikul W, Kayee T. Diagnostic indicators for peptic ulcer perforation at a tertiary care hospital in Thailand. Clin Exp Gastroenterol. 2011;4:283-9.
Soreide K, Thorsen K, Harrison EM, et al. Perforated peptic ulcer. Lancet. 2015;386(10000):1288-98.
Lanas A, Carrera-Lasfuentes P, Garcia-Rodriguez LA, et al. Outcomes of peptic ulcer bleeding following treatment with proton pump inhibitors in routine clinical practice: 935 patients with high- or low-risk stigmata. Scand J Gastroenterol. 2014;49(10):1181-90.
Baghdanian AH, Baghdanian AA, Puppala S, Tana M, Ohliger MA. Imaging Manifestations of Peptic Ulcer Disease on Computed Tomography. Semin Ultrasound CT MR. 2018;39(2):183-92.
Eisner F, Hermann D, Bajaeifer K, Glatzle J, Konigsrainer A, Kuper MA. Gastric Ulcer Complications after the Introduction of Proton Pump Inhibitors into Clinical Routine: 20-Year Experience. Visc Med. 2017;33(3):221-6.
Smith RS, Sundaramurthy SR, Croagh D. Laparoscopic versus open repair of perforated peptic ulcer: A retrospective cohort study. Asian J Endosc Surg. 2018.
Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician. 2007;76(7):1005-12.
Hainaux B, Agneessens E, Bertinotti R, et al. Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR Am J Roentgenol. 2006;187(5):1179-83.
Tanaka R, Kameyama H, Nagahashi M, et al. Conservative treatment of idiopathic spontaneous pneumoperitoneum in a bedridden patient: a case report. Surg Case Rep. 2015;1(1):69.
Shibukawa N, Ouchi S, Wakamatsu S, Wakahara Y, Tatsumi N, Kaneko A. A Rare Case of Gastric Ulcer Penetrating the Pancreas that was Successfully Managed by Conservative Therapy. Intern Med. 2017;56(17):2277-9.
Sheikh MT, Sheikh MT, Jan M, Khan HA, Vashisht GP, Wani ML. Role of Multi-Detector CT (MDCT) in Evaluation of Bowel Diseases. J Clin Diagn Res. 2017;11(7):Tc11-tc3.
Oguro S, Funabiki T, Hosoda K, et al. 64-Slice multidetector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract. Eur Radiol. 2010;20(6):1396-403.
Mularski RA, Sippel JM, Osborne ML. Pneumoperitoneum: a review of nonsurgical causes. Crit Care Med. 2000;28(7):2638-44.
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