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Perforated ulcer; Other names: Ruptured ulcer: Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper gastrointestinal hemorrhage and could potentially lead to perforation. Specialty: Gastroenterology Symptoms: Abdominal pain, vomiting, nausea: Complications: Bowel perforation, sepsis ...
Complications include a painful inflammation of the inner lining of the abdominal wall and sepsis. Perforation may be caused by trauma, bowel obstruction, diverticulitis, stomach ulcers, cancer, or infection. [2] A CT scan is the preferred method of diagnosis; however, free air from a perforation can often be seen on plain X-ray. [2]
Duodenal causes: Duodenal ulcer; Vascular malformation, including aorto-enteric fistulae. Fistulae are usually secondary to prior vascular surgery and usually occur at the proximal anastomosis at the third or fourth portion of the duodenum where it is retroperitoneal and near the aorta. [5] [6] [7] Hematobilia, or bleeding from the biliary tree
The duodenal bulb is the site of duodenal ulcer occurrence. Duodenal ulcers are more common than gastric ulcers and - unlike gastric ulcers - are caused by increased gastric acid secretion. Duodenal ulcers are commonly located anteriorly, and rarely posteriorly. Anterior ulcers can be complicated by perforation, while the posterior ones bleed.
Posterior gastric wall perforation may lead to bleeding due to the involvement of gastroduodenal artery that lies posterior to the first part of the duodenum. [23] The death rate in this case is 20%. [ 16 ]
The gastroduodenal artery can be the source of a significant gastrointestinal bleed, which may arise as a complication of peptic ulcer disease.Because of its close relationship to the posteromedial wall of the second part of the duodenum, deeply penetrating ulcers or tumours of the duodenum may cause torrential bleeding from the gastroduodenal ‘artery of haemorrhage'. [1]
Gastric ulcer in antrum of stomach with overlying clot due to gastric lymphoma. Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper GI hemorrhage .
The cause for Valentino's syndrome is due to a perforated ulcer located in the duodenum. This occurs when ulcers that have gone untreated for long periods of time, and as a result has burned through the stomach wall. Risk factors for a perforated ulcers include bacterial infection, such as H. pylori, and routine use of nonsteroidal anti ...