[Gastroduodenal ulcer refractory to conservative treatment]. / Ulcerul gastro-duodenal refractar la tratamentul conservator.

This is a 20-year retrospective study on 205 patients in which surgery for gastroduodenal ulcer was performed. In 51 one of these patients (24,8%) surgery was required by drug therapy failure, cases labeled as drug-resistant ulcers. Some causes of drug therapy failure are discussed, failure being also recorded in patients who benefited from modem ulcer drugs that proved only partially effective. The authors emphasize that surgery can no longer represent a therapeutic option, an utter substantiation not only from the surgeon but also from the entire team of specialists in various investigation types and therapeutics being mandatory.

[Perforated gastroduodenal stress ulcer]. / Ulcerul gastro-duodenal de stres perforat consideratii asupra patru cazuri.

Experimental and clinical data support the role of oxidative stress in the development of gastro-duodenal inflammatory lesions and peptic ulcer. Although quite common, stress ulcer remains a minor concern in the The authors review the literature data and perform a retrospective study on 205 personal cases of gastroduodenal ulcers, diagnosed and operated in the period 1986-2005. Of these, 58 (28.29%) were perforated ulcers, including 4 cases (6.8%) caused by various psychic traumas. All the patients presented symptoms and signs characteristic for perforated ulcer and were undoubtedly of psychogenic cause. The surgical treatment consisted in the closure of the perforation and peritoneal drainage. Besides medical treatment of peptic ulcer disease consisting of antisecretory drugs, antioxidants and sedatives were used. Postoperative follow-up showed a rapid and uneventful recovery in all cases. In conclusion, surgery is the mainstay of treatment in perforated ulcer, but additional stress therapy promotes healing and may reduce postoperative morbidity in cases with certain involvement of psychic trauma.