Change in prevalence and pattern of peptic ulcer disease in the Northern Savannah of Nigeria: An endoscopic study

Background: Peptic ulcer disease (PUD) is common worldwide. Its incidence and prevalence have been declining in recent years in developed countries, and a similar trend has been observed in many parts of Africa including Nigeria. Aim: This study aimed to provide an endoscopic update on PUD in the Northern Savannah of Nigeria and compare with past reports from the region and recent reports from Nigeria, Africa, and the rest of the world. Methods: Upper gastrointestinal endoscopy records of consecutive patients diagnosed with PUD between January 2014 and September 2022 at an endoscopy unit of a tertiary institution in North West Nigeria were retrieved and demographic data, types of peptic ulcer, and their characteristics were extracted and analyzed. Results: Over a 9 year period, 171/1958 (8.7%) patients were diagnosed with PUD: mean age 48.8 years (range 14­85), 68.4% male, and 70% >40 years. 59.6% were gastric ulcers (GU), 31.6% duodenal ulcers (DU), and 8.8% were both. The mean age of patients with GU was slightly higher than those with DU (49.9 years vs. 46.6 years, P = 0.29); patients aged 40 years significantly more GU than DU (74.6% vs. 54.7%, P = 0.016). There were no significant gender differences between GU and DU. Conclusion: The prevalence and pattern of PUD in Northern Savannah of Nigeria have changed ­ patients were predominantly male and older, and GU predominated.

Management of Helicobacter pylori among medical doctors working in Khartoum, Sudan 2019: a cross-sectional study

Background: Various international guidelines have been developed regarding Helicobacter pylori (H. pylori) management, as it is infecting more than half of the world's population. Sudan's health system lacks guidelines regarding H. pylori management, leading to a discrepancy in practice. Investigating the current approach could be a step forward in the formulation of a national consensus in the management of H. pylori. Methods: A cross-sectional study was conducted among medical doctors currently working in Khartoum, Sudan. Participants were enrolled from platforms of medical associations through an online questionnaire. The questionnaire was scored out of 25 points, and scoring 13 or above considered a good approach. Data analysis was carried out using Statistical Package for Social Sciences (SPSS). Results: A total of 358 medical doctors participated in the study. The mean (±SD) score was 12.9(±4.5). Those who were using textbooks, campaigns, symposiums or general medical information to their primary Source of knowledge significantly scored higher. The most selected indication for both diagnosis (76.8%) and treatment (67.6%) was an active peptic ulcer. Stool antigen test (SAT) was the most preferred test (70.7%). The majority of respondents selected triple therapy (82.1%) as a first-line regimen. Only 37.7% confirmed the eradication after four weeks of stopping the treatment. They ensure eradication mainly through SAT (29%). Conclusion: A suboptimal approach was noted among medical doctors of Khartoum, Sudan, regarding H. pylori management. Efforts should be invested in forming national guidelines and the implementation of continuous medical education programs.

Sero-prevalence of and risk factors associated with Helicobacter pylori infections among individuals with peptic ulcer in Owerri, Imo State, Nigeria during 2020-2021

Background: Helicobacter pylori, which is a causative agent of chronic gastritis, duodenal ulcer and gastric cancer, presently affects approximately one half of the world population. This study was conducted to assess the epidemiology and risk factors for acquisition of H. pylori among individuals with and without peptic ulcer symptoms in Owerri, Nigeria, in order to provide baseline data and create awareness for effective management and prevention of infection caused by this pathogen. Methodology: A total of 384 participants, symptomatic and asymptomatic for peptic ulcer, were recruited from the three Local Government Areas (LGAs) of Owerri, Imo State, Nigeria. The symptomatic participants were randomly recruited among patients attending outpatient clinics with symptoms of peptic ulcer disease at the Federal Medical Center Owerri, general hospitals and primary healthcare centers across Owerri LGAs, while asymptomatic patients were recruited from the community. Information on socio-demographic characteristics of each participant and potential risk factors were collected with a pre-tested structured questionnaire. Blood samples were collected for detection of antibodies (IgG) using a one-step H. pylori test device while faecal samples were collected for detection of occult blood (from peptic ulceration) using faecal occult blood (FOB) test. Data were analyzed using SPSS version 25.0 and association of risk factors with H. pylori sero-prevalence was determined by the Chi-square or Fisher Exact test (with Odds ratio). P value < 0.05 was considered statistically significant.Results: The sero-prevalence of H. pylori infection among the study participants was 72.4% (285/384) while the prevalence of ulcer by FOB test was 71.1% (273/384). A total of 78.4% (214/273) of those with ulcers were seropositive for H. pylori while 64.0% (71/111) of those without ulcers were sero-positive for H. pylori (p=0.0045).Factors significantly associated with high sero-prevalence of H. pyloriwere age groups 41-50 (100%), 21-30 (78.4%) and 31-40 (67.6%) years (X 2=66.964, p<0.0001), illiteracy (OR=6.888, p<0.0001), unemployment (OR=2.427, p<0.0001), low social class status (X2=28.423, p=0.0003), drinking of unclean water (OR=5.702, p<0.0001), living in crowded rooms (OR=2.720, p<0.0001), eating food bought from food vendors (OR=3.563, p<0.0001), family history of ulcer (OR=12.623, p<0.0001), habits of eating raw vegetables and unwashed fruits (OR=6.272, p<0.0001), non-regular hand washing practices before meal (OR=2.666, p<0.0001) and presence of ulcer (OR=2.043, p=0.0045). However, smoking (OR=0.7581, p=0.2449) and gender (OR=0.6538, p=0.0796) were not significantly associated with sero-prevalence of H. pylori. Conclusion: There is need for comprehensive strategy including public health education campaign to create awareness on H. pylori, improve personal hygiene and environmental sanitation, provision of safe drinking water by the government to the populace, and discourage indiscriminate and open defecation

Five-year Prevalence of Gastrointestinal Diseases and Disorders in Akure South, Nigeria

The burden of gastrointestinal diseases and disorders (GIDD) remains high in Nigeria and varies across regions. This study wa s therefore designed to examine the prevalence of gastrointestinal diseases and disorders over a period of 5-years from January 2014 to December 2018 in Akure South of Ondo state, Nigeria. Descriptive retrospective study was employed and the medical records of all patients diagnosed for GIDD in the two selected health facilities were reviewed within the study period. In total, 12,323 medical records of patients with GIDD were included in this study. The prevalence of GIDD were 44.9% in the year 2014 with the lowest prevalence of 6.7% occurring in the year 2018. Over the 5-years period, lower GIDD cases were 91% compared to upper GIDD that was 9%. Peptic ulcer had the highest prevalence (55%) of lower GIDD followed by gastroenteritis (30%). Hiatal hernia had the highest prevalence (84%) for upper GIDD followed by dyspepsia (11%) and Gastroesophageal reflux disease (5%). Over a 5-year period, the prevalence of gastrointestinal disease and disorders in Akure south in this study shows that lower GIDD is more prevalent in the study area with peptic ulcer as the most predominant GIDD among the study population.

Prevalence of helicobacter pylori infection among suspected peptic ulcer patients in Port Harcourt, Southsouth, Nigeria

Background information Helicobacter pylori is a ubiquitous organism that causes infections that are asymptomatic, and with no specific clinical signs and symptoms. Various diagnostic tests for H. pylori have been developed. This study was intended to understand the prevalence of H. pylori among suspected peptic ulcer patients in a tertiary medical facility in Port Harcourt. Methodology The ninety-eight (98) patients who consented were properly instructed before being given a capsule containing urea. This was swallowed with 50mls of water and they waited for ten minutes, after which, they breathed into a breath card until the indicator changed colour from orange to yellow. The breath card was then inserted into a device which detects the production or otherwise of the carbon dioxide with isotopically labelled carbon by displaying positive if present or negative if absent.Result In this study, out of the forty-five male and fifty-three female subjects that participated in this study, a study prevalence of 39.8% was observed. Also, a male to female prevalence ratio of 15.3:24.5 was observed with no statistical significance (X2=0.1519, P=0.6911). Similarly, the age group distribution of H. pylori infection among the male population showed age group 41-50 years as the modal (11.6%) prevalence, followed by age group 51-60 years (9.3%) with P>0.05 (X2=3.478, P=0.7470). In the same vein, the female distribution of H. pylori infection revealed that there was no significance among the different study groups with P>0.05 (X2=3.115, P=0.7943) and age group 31-40 years (16.1%) had the modal prevalence. Conclusion The high incidence of H. pylori infection among suspected peptic ulcer patients in Port Harcourt has been established, though not as high as other studies elsewhere. Therefore, public enlightenment should be encouraged by all public health stakeholders to arrest this trend

Peptic ulcer Disease drugs usage patterns and its economic burden in a tertiary health institution in Niger Delta, Nigeria

Background: Drug utilization evaluation for peptic ulcer disease and its cost implication are rare in Niger Delta. The objective of the study was to evaluate drug usage pattern in peptic ulcer diseases as well as its cost implications.Methods: The cross sectional drug use evaluation study involving the use of questionnaire and patient case notes was carried out in a tertiary health institution. The validated pretested questionnaire was interviewer administered to 300 patients sampled consecutively followed by a retrospective review of their respective case notes between April to November 2013. Information collected include risk factors, prescribed drugs, Helicobacter pylori assay test results among others. Cost of each drug and therapy were then computed appropriately. Data was analyzed using Statistical package for Social Sciences (SPSS) version 20, Microsoft Excel and Graph Pad Prism for windows Instat Version 3.Results: Out of the 300 patients, H. pylori test was conducted in 262 (87.3%) while the presence or absence of the organisms could not be confirmed in the remaining 38 subjects. Out of the 262 patients with H. pylori test results, only 166 representing 63.4% were positive. History of non-steroidal anti-inflammatory drugs (NSAID) usage was very high among the subjects (250; 83.3%) and highest for ibuprofen 146 (48.7%). The most prescribed drugs were antacids (268; 89.3%), amoxicillin (165; 55.0%), and a combined formulation of omeprazole, tinidazole, and clarithromycin in 140 (46.7%) subjects, followed by omeprazole alone (125; 41.7%).The national direct cost implication for the estimated 17.6 million is in the range of NGN186,849,000,000.00 ($958,200,000.00), out which NGN109,867,000,000.00($563,420,513.00) was for PUD drugs (50.9%) and NGN32,698,575,000.00 ($167,685,000.00) for H. pylori tests (17.5%), while the remaining 31.7% valued at NGN59,231,133,000.00 ($303,749,400.00) was for non-ulcer drugs, personnel and transportation.Conclusion: The pattern of drugs usage is consistent with standard treatment guidelines. Peptic ulcer drugs for the 300 subjects constituted NGN1,618,641 ($8300.72) which represents 73.0% of the total amount spent on drugs. The national direct cost of PUD is close to NGN200 billion ($1.04 billion). Updated information on drug usage and their costs is needed for improved usage and system efficiency

Incidence and Clinical Features of Bleeding Peptic Ulcers in Acute Upper Gastrointestinal Bleeding: -Experience of Moroccan University Hospital Unit

Introduction: Peptic ulcer disease (PUD) has been recognized as the leading cause of acute upper gastrointestinal bleeding (AUGIB). This study aims to report general features of bleeding peptic ulcers in patients who benefit of urgent endoscopy in our department after an acute upper gastrointestinal hemorrhage. Results: A total of 1809 patients were explored for acute upper gastrointestinal bleeding in our unit since 2003 to 2008. Gastroduodenal peptic ulcers were the most frequent diagnosed etiology. They present 38% of all reported causes of bleeding (n=527) (table I). 25% were located at duodenal mucosa (n= 347) and 13% were gastric ulcers (n=180). No esophageal ulcers were reported. Incidence of both duodenal and gastric ulcers decreases during the last years. Conclusion: In our department; incidence of bleeding peptic ulcer disease is decreasing but they continue to be the first cause of AUGIB

Analyse démographique et endoscopique des patients atteints d'ulcère gastroduodénal à Yaoundé au Cameroun : qu'est ce qui a changé depuis les années 1990 ?

Objectif : La prévalence de l'ulcère gastro-duodénal semble être en diminution marquée ces dernières années dans les pays africains. Au Cameroun en 1990, elle était de 32%. L'objectif de notre étude était d'évaluer l'évolution de la prévalence de l'ulcère gastroduodénal et d'identifier ses caractéristiques démographiques et endoscopiques à Yaoundé, 25 ans après.Patients et méthodes : Etude rétrospective de la période allant du 1er janvier 2011 au 31 décembre 2014 dans trois hôpitaux universitaires de Yaoundé. Les comptes rendus d'endoscopie de 4685 patients consécutifs référés pour une endoscopie digestive haute ont été réexaminés. Nous avons inclus 489 patients (312 hommes et 177 femmes) avec un ulcère gastro-duodénal prouvé en endoscopie. Les données démographiques et endoscopiques ont été recueillies. Résultats : L'ulcère duodénal et l'ulcère gastrique étaient identifiés respectivement chez 295 (60,3%) et 157 (32,1%) patients, la double localisation gastrique et duodénale chez 37(7,6%), faisant une prévalence globale de 10,4%. L'âge moyen des patients était de 48,9 ans (extrêmes : 4 à 90 ans). Les patients ulcéreux gastriques étaient relativement plus âgés que les patients ulcéreux duodénaux (54,4 ans vs. 45,4 ans, p < 10-5). Le ratio homme/femme était de 2,2/1 pour l'ulcère duodénal et 1,2/1 pour l'ulcère gastrique. La prévalence globale de l'infection à H. pylori à l'histologie et/ou au test rapide à l'uréase était de 63,0% (308/489). L'infection était plus fréquente dans l'ulcère duodénal que gastrique (67,8% vs. 51,0%, p = 0,0005). L'ulcère gastro-duodénal était révélé par les épigastralgies (71,8%) et l'hémorragie (31,5%). L'hémorragie était liée à l'ulcère duodénal (p = 0,07) et au sexe masculin (p = 0,01). Il n'y avait pas de différence significative selon l'âge (p = 0,16). H. pylori protégeait contre l'hémorragie, risque relatif 0,7 (IC à 95% : 0,6-0,8 ; p = 0,00006).Conclusion : La prévalence de l'ulcère gastroduodénal a significativement diminué au Cameroun par rapport à 1990. Les patients ulcéreux sont devenus plus âgés avec une tendance à l'occidentalisation de la maladie ulcéreuse

Surgical outcomes for perforated peptic ulcer: a prospective case series at an academic hospital in Monrovia, Liberia

Introduction The incidence of perforated peptic ulcer remains high in low and middle-income countries. Mortality can be significant; and early surgical management with careful evaluation of pre-operative risk factors is essential. The purpose of this study was to describe the clinical outcomes of surgical treatment for perforated peptic ulcer disease in Liberia and to explore risk factors for adverse outcomes.Methods This study prospectively examined 20 consecutive patients undergoing primary closure with omental patch for perforated pre-pyloric or duodenal peptic ulcer at the John F. Kennedy Medical Centre (JFKMC) in Monrovia; Liberia from May 2009 to March 2010. Pre-operative information was captured in a questionnaire. Risk factors were assessed for univariate and multivariate associations with in-hospital mortality.Results Median age was 33 years and 85 were males. A majority of the patients (70) had a history of gastritis and antacid use. Median time from beginning of symptoms to surgery was 4.5 days. Over-all in-hospital mortality following surgical therapy for perforated peptic ulcer disease was 35. Median length of stay among survivors was 16 days; and death occurred at median 1 day after admission. Long symptom duration and age 30 years of age were significantly associated with in-hospital mortality on univariate (? = 2.60 [0.18-5.03]; p = 0.035) and multivariate testing (? = 2.95 [0.02-5.88]; p =0.049). Conclusion Peptic ulcer disease and its treatment represent a potentially substantial source of morbidity and mortality in limited-resource settings. In this case series; surgical treatment for perforated peptic ulcer disease carried a high mortality; and the results highlight the potential for public health systems strengthening to prevent poor health outcomes. Peptic ulcer disease in low- and middle-income countries presents unique epidemiology and treatment challenges that may differ significantly from evidence-based guidelines in high-income countries

Analyse des habitudes alimentaires des patients souffrant d'ulcère gastro-duodénal en consultation à l'Hôpital National de Niamey

Il a été procédé par une étude du type descriptive prospective du 1er novembre 2014 au 31 décembre 2014 sur l'analyse des habitudes alimentaires des personnes souffrant d'ulcère gastro-duodénal. Les objectifs de cette étude étaient de dégager les habitudes alimentaires des malades ulcéreux, les facteurs favorisant le développement de l'ulcère liés à l'habitude de vie et aux services de santé. L'ulcère gastro-duodénal connait depuis quelques années une fréquence importante parmi les maladies digestives et le nombre de cas de cette pathologie est en augmentation durant ces trois (3) dernières années au Niger (données S.N.I.S). Les facteurs de risque de la maladie ulcéreuse sont liés aux conditions hygiéno-diététiques des personnes, au stress et à l'infection d'Helicobacter pylori. Dans notre population, les conditions hygiéno-diététiques acceptables ne sont pas assurées. Aucune étude sur les ulcères gastro-duodénaux n'a été faite depuis 1985 au Niger, sauf en 2007 par Mahaman Issiakou c'est compte tenu de ces raisons que nous avons choisi de mener cette étude. L'étude a porté sur un échantillon de 90 malades ulcéreux sans limite d'âge ayant effectués l'examen de fibroscopie et 10 agents de santé. Les techniques de collecte de données utilisées étaient l'entretien avec les malades ulcéreux et l'administration du questionnaire aux agents de santé. Des résultats de cette étude, il ressort que les femmes sont plus touchées que les hommes avec 66,66 % des patients ulcéreux de sexe féminin et 33, 34 % de sexe masculin. 77,77% de nos malades ulcéreux sont des consommateurs d'excitants et que ces excitants constituent un facteur d'agression de la couche protectrice de la muqueuse. 17% de ces patients prennent la cola. Les excitants sont des facteurs de risque de la maladie ulcéreuse. Plus de la moitié des ulcéreux consomment des Antiinflammatoires Non Stéroïdiens (A.I.N.S), et ils font aussi recours au traitement traditionnel en cas des maladies. 77% des patients ont entendu parler de l'ulcère, c'est donc une maladie connue. Ces ulcéreux consomment des repas épicés, consomment des aliments aigres et en mangent des aliments graissés. Nos patients mangent des aliments favorisant l'apparition de l'ulcère. La majorité de nos ulcéreux sont stressés. Plus de la moitié consultent dans les formations sanitaires plus d'un an. Nos malades ont des manifestations typiques ulcéreuses. L'épigastralgie est plus fréquente parmi les signes des manifestations cliniques d'ulcère. 8 malades ont eu à faire leur contrôle durant notre étude ; parmi eux, 77,77% étaient satisfaits de la prise en charge. L'ulcère duodénal domine sur l'ulcère gastrique. Leur rapport est 2,77 à l'avantage de l'ulcère duodénal. Néanmoins, l'ulcère gastrique est plus fréquent chez la femme que chez l'homme avec un rapport de 1,08. Pour prévenir l'ulcère, nous formulons quelques recommandations : -Mener une politique de sensibilisation de la population sur les dangers de la prise excessive de certains excitants et sur la nécessité d'une consultation médicale le plus tôt possible en cas de manifestation clinique ulcéreuse. -Former les spécialistes en matière de gastro-entérologie qui assureront la bonne fonctionnalité du service. -Faire un traitement précoce de l'ulcère par l'éradication d'Hélicobacter Pylori qui est un facteur très important de l'ulcère. -Equiper le service de la médecine B3 par une nouvelle fibroscopie pour rendre plus accessibles les services à la population, et réparer l'ancienne

Evaluation of Antiulcer Properties of Ethanolic and Hot Aqueous Stem Extracts of Synclisia Scabrida on Experimentally Induced Ulcer Models in Albino Mice

Background : The treatment of peptic ulcer disease poses therapeutic challenges to both patients and physicians alike because of the tendency of ulcers to relapse. Drugs used in the treatment of this disease are either costly or are associated with high incidence of adverse effects. Synclisia scabrida is a plant used in ethnomedicine for the treatment of various forms of stomach disorders and menstrual pains. The medicinal properties of the plants are claimed to reside in the roots; stems; and the leaves. Aim : This study; therefore; is to verify this claim and elucidate the probable mechanism of action by using crude stem extracts of this plant on drug- and stress-induced ulcer models in albino mice. Materials and Methods : Crude ethanol and hot water extracts; EE and HWE respectively; of the stem were prepared. These extracts were fractionated and separated by chromatographic methods and the fractions pooled together as fractions (PF-1; PF-2; PF-3 respectively) based on their chromatographic mobility and color reactions. Phytochemical analysis was done on the extracts. Ulcer models were induced in albino mice by means of indomethacin; histamine; and stress after prior cytoprotection with orally administered crude extracts and control (cimetidine). Results : Phytochemical analysis of the crude extracts and their fractions revealed the presence of cardiac glycosides (+++); tannins (+++); saponins (+); flavonoids (++); carbohydrates (++) and alkaloids (+++). Acute toxicity study on the crude extracts and their fractions revealed relative safety at the dose of 5000 mg/kg. The crude extracts (EE and HWE) and their fractions (PF-1; PF-2; PF-3) significantly (P = 0.001) protected against indomethacin-; histamine- and stress-induced ulcers. The decrease in GIT motility produced by these extracts was comparable to that produced by atropine sulfate. Conclusion : The findings suggest that these extracts of Synclisia scabrida possess antiulcer and antispasmodic properties; which justify the claims for its use in the treatment of various forms of stomach disorders

Evaluation of Antiulcer Properties of Ethanolic and hot Aqueous Stem Extracts of Synclisia Scabrida on Experimentally Induced Ulcer Models in Albino Mice

The treatment of peptic ulcer disease poses therapeutic challenges to both patients and physicians alike because of the tendency of ulcers to relapse. Drugs used in the treatment of this disease are either costly or are associated with high incidence of adverse effects. Synclisia scabrida is a plant used in ethnomedicine for the treatment of various forms of stomach disorders and menstrual pains. The medicinal properties of the plants are claimed to reside in the roots; stems; and the leaves. Aim : This study; therefore; is to verify this claim and elucidate the probable mechanism of action by using crude stem extracts of this plant on drug- and stress-induced ulcer models in albino mice. Materials and Methods : Crude ethanol and hot water extracts; EE and HWE respectively; of the stem were prepared. These extracts were fractionated and separated by chromatographic methods and the fractions pooled together as fractions (PF-1; PF-2; PF-3 respectively) based on their chromatographic mobility and color reactions. Phytochemical analysis was done on the extracts. Ulcer models were induced in albino mice by means of indomethacin; histamine; and stress after prior cytoprotection with orally administered crude extracts and control (cimetidine). Results : Phytochemical analysis of the crude extracts and their fractions revealed the presence of cardiac glycosides (+++); tannins (+++); saponins (+); flavonoids (++); carbohydrates (++) and alkaloids (+++). Acute toxicity study on the crude extracts and their fractions revealed relative safety at the dose of 5000 mg/kg. The crude extracts (EE and HWE) and their fractions (PF-1; PF-2; PF-3) significantly (P = 0.001) protected against indomethacin-; histamine- and stress-induced ulcers. The decrease in GIT motility produced by these extracts was comparable to that produced by atropine sulfate. Conclusion : The findings suggest that these extracts of Synclisia scabrida possess antiulcer and antispasmodic properties; which justify the claims for its use in the treatment of various forms of stomach disorders

Les ulceres gastro duodenaux en milieu rural au Mali

Le but de notre travail etait de preciser les aspects epidemiologiques; cliniques et endoscopiques des ulceres gastro duodenaux a l'Hopital Regional de Sikasso (HRS). Cette etude prospective s'etait deroulee de janvier 2002 a decembre 2003. Tous les patients ont subi une endoscopie digestive haute. Les ulceres gastro duodenaux ont represente 10;88de l'ensemble des endoscopies digestives. L'age moyen des patients etait de 42;51 + 14;60 ans avec un sex-ratio de 1;88 en faveur des hommes. Les couches socioprofessionnelles a revenu modeste etaient les plus representees. Les principaux signes cliniques etaient l'epigastralgie et la dyspepsie. L'ulcere siegeait tres souvent au bulbe

Traitement medical de l'ulcere gastroduodenal

N.A.

Changing Concepts in the Management of Peptic Ulcer

Over the years; the treatment of duodenal ulcer disease seems to be based on beliefs and scattered facts with weak scientific basis. There is little evidence that the use of antacids; anti-secretory drugs; diet regulation; sedatives and pepsin inhibitors; even though they reduce the ulcer pain; prevent recurrence of ulcer and healing of ulcer in all cases. Recently; the finding of Helicobacter pylori in association with peptic ulcer disease seems to confirm that this is probably a most important aetiological factor for peptic ulcer disease. Presently; treatment of peptic ulcer is directed at eradicating this bacterium. This review paper highlights the evolution of the surgical procedures for peptic ulcer disease

La prise en charge de la maladie ulcereuse gastro-duodenale

N.A.

Pancreaticoduodenostomy for treatment of giant duodenal ulcer : case report

Definitive acid-reducing peptic ulcer surgery currently plays a less prominent role than medical treatment in the management of peptic ulceration. The utilisation of proton pump inhibitors and Helicobacter eradication are proven effective therapies. Giant duodenal ulcers; first described by Brdiczka in 1931; pose a unique challenge to this shift in therapy. There are various described surgical options to deal with these ulcers depending on the operative findings and we describe a simple new technique that we recently used successfully