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Surg Infect (Larchmt) 2019 Apr 2. Epub 2019 Apr 2.

1 Department of Surgery, Washington University in Saint Louis, Saint Louis, Missouri.

Background: The link between Helicobacter pylori infection and peptic ulceration is well established. Recent studies have reported a decrease of H. pylori-related peptic ulcer disease; Helicobacter pylori eradication is likely the cause of this decrease. Read More

Khirurgiia (Mosk) 2019 (3):88-97

Vishnevsky National medical research center of surgery of Ministry of Health of Russia, Moscow, Russia.

In the following article, we present the key trends in emergency surgical care in the Russian Federation between 2000 and 2017. The study used data from federal statistical observations and a survey of state medical institutions in 80 regions encompassing 99.3% of the country's population. Read More

J Gastroenterol Hepatol 2019 Mar 28. Epub 2019 Mar 28.

Division of Gastroenterology, Chulalongkorn University and King Chulalongkorn Memorial Hospital The Thai Red Cross, Bangkok, Thailand.

Background: Long-term use of dual antiplatelets is increasing, and most patients need primary peptic ulcer prophylaxis. The long-term use of proton pump inhibitors (PPIs) is associated with adverse events. We evaluated the efficacy of rebamipide for peptic ulcer prevention. Read More

Int J Surg 2019 Apr 11;64:24-32. Epub 2019 Mar 11.

Newcastle-Upon-Tyne Hospitals Foundation Trust, United Kingdom.

Background: The management of perforated peptic ulcers has evolved over time and includes laparoscopic or open repair, and conservative management. The utilisation of, and outcomes from these strategies are not clear. Trends in epidemiology, management and outcomes for perforated peptic ulcer across the North of England over a 15-year period were analyzed. Read More

Arch Acad Emerg Med 2019 3;7(1):e12. Epub 2019 Jan 3.

Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.

Peptic ulcer disease is a common gastrointestinal disorder, the prevalence of which has reduced in recent years due to effective new treatments. Peptic ulcer perforation is an emergent life-threatening condition that causes pneumoperitoneum and septic shock. It often requires surgical procedures. Read More

Int J Surg Case Rep 2019 1;56:29-31. Epub 2019 Feb 1.

Department of Physical Medicine and Rehabilitation, AIIMS Bhubaneswar, India. Electronic address:

Introduction: Peptic perforation repair is a common stomach surgery. This surgery has not been associated with delayed onset gastrocutaneous fistula formation. However such a complication has been reported following a variety of other stomach surgeries. Read More

BMJ Case Rep 2019 Feb 26;12(2). Epub 2019 Feb 26.

Internal Medicine, Hospital Beatriz Angelo, Loures, Lisboa, Portugal.

Arterioportal fistulas are a rare complication of abdominal interventions. They can remain asymptomatic for a long time and manifest with symptoms of portal hypertension. We present the case of a 65-year-old man admitted to the emergency room with increasing fatigue and melena. Read More

Surg Endosc 2019 Feb 25. Epub 2019 Feb 25.

Endoscopic Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China.

Aim: To investigate the effectiveness of over-the-scope-clip (OTSC)-based endoscopic closure in patients with perforated peptic ulcer (PPU).

Methods: One hundred six patients diagnosed with PPU were treated with either OTSC (n = 26) or conservative treatments (n = 80), respectively. The outcome assessments included technical success rate, clinical success rate, post-treatment complications after 1 month, mortality rate, time to resume oral feeding, length of hospital stay, and the administration of antibiotics. Read More

Rozhl Chir Winter 2019;98(1):14-17

Introduction: Acute abdomen is one of the most important issues in abdominal surgery. Our study aims to describe the differences in clinical presentation of patients, in the course of their hospitalization, and in morbidity and mortality of patients with drug abuse; another aim is to describe our own experience with drug abusers with acute abdomen. Method: Patients with the history of drug abuse and with non-traumatic acute abdomen were included retrospectively to our set. Read More

Wideochir Inne Tech Maloinwazyjne 2019 Jan 11;14(1):60-69. Epub 2018 Jun 11.

Department of Surgery 1, Yerevan State Medical University, Yerevan, Armenia.

Introduction: Perforation is a dangerous complication of peptic ulcer disease and requires emergency surgical treatment. In recent decades laparoscopic repair of duodenal perforation has been widely used in emergency abdominal surgery.

Aim: To analyze laparoscopic and open surgical treatment of 120 consecutive patients with perforated duodenal ulcer. Read More

Int J Surg Case Rep 2019 1;55:171-173. Epub 2019 Feb 1.

Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.

Introduction: Peptic ulcer perforation is a common surgical emergency that is a complication of 9% of patients with peptic ulcer disease (Kjetil et al., 2015 [1]). Despite advances in the management of peptic ulcer disease, the number of acute complications have remained constant. Read More

Surg Infect (Larchmt) 2019 Feb 8. Epub 2019 Feb 8.

Kirikkale University School of Medicine, Department of General Surgery, Kirikkale, Turkey.

Background: Despite surgical treatment of peptic ulcer perforation (PUP), the high rates of morbidity and mortality have motivated researchers to search for new laboratory markers to predict morbidity and mortality. The aim of this study was to investigate the relation between pre-operative laboratory values and demographic factors and post-operative mortality in patients undergoing surgery for PUP.

Patients And Methods: A retrospective study was made of the clinical findings and laboratory data of patients operated on for a diagnosis of PUP in the general surgery clinic between 2014 and 2018. Read More

Korean J Gastroenterol 2018 Nov;72(5):262-266

Division of Gastroenterology, Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Surgery has been the standard treatment for perforated duodenal ulcers, with mostly good results. However, the resolution of postoperative leakage after primary repair of perforated duodenal ulcer remains challenging. There are several choices for re-operation required in persistent leakage from perforated duodenal ulcers. Read More

J Cardiol Cases 2018 Dec 2;18(6):201-203. Epub 2018 Oct 2.

Department of Cardiology, Helios University Hospital and University of Witten/Herdecke, Wuppertal, Germany.

Introduction: Acute tension pneumopericardium due to gastric perforation is a rare and often lethal condition. Only a few case reports have been described in the literature. Diagnosis based on clinical evaluation is difficult and it is usually made incidentally upon computed tomography (CT) or plain radiography of the chest. Read More

Transplant Proc 2018 Dec 29;50(10):3973-3977. Epub 2018 May 29.

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

A patient who had previously undergone a gastrectomy due to gastric ulcer perforation was admitted to our hospital. He presented with epigastric pain and poor oral intake accompanied with gastrointestinal bleeding, and was diagnosed with gastric stump cancer. He had a history of renal transplantation and was administered immunosuppressive agents. Read More

Chest 2018 Dec;154(6):e181-e185

Department of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:

Case Presentation: A 57-year-old man was admitted for 1 month of accelerating hemoptysis and hematemesis. Two weeks earlier, he first presented with fevers and hemoptysis of 2 weeks' duration and was diagnosed with community-acquired pneumonia treated with 5 days of ceftriaxone and azithromycin. He improved and was discharged, but his hemoptysis recurred 1 day after discharge and progressed over 9 days, leading to the present admission. Read More

J Gastrointest Surg 2019 Mar 21;23(3):618-625. Epub 2018 Nov 21.

The Whiteley-Martin Research Centre, Discipline of Surgery, Nepean Hospital, The University of Sydney, Level 5, South Block, P.O. Box 63, Penrith, NSW, 2751, Australia.

Purpose: Over the last 3 decades, laparoscopic procedures have emerged as the standard treatment for many elective and emergency surgical conditions. Despite the increased use of laparoscopic surgery, the role of laparoscopic repair for perforated peptic ulcer remains controversial among general surgeons. The aim of this study was to compare the outcomes of laparoscopic versus open repair for perforated peptic ulcer. Read More

Pediatr Surg Int 2019 Apr 17;35(4):473-477. Epub 2018 Nov 17.

The Research Institute at Nationwide Children's Hospital, The Ohio State University School of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.

Objective: The aim of this study was to investigate the pathogenesis, symptoms and individualized surgical management in pediatrics with gastroduodenal perforation (GDP).

Methods: Patients diagnosed with GDP from January 2013 to December 2016 in our hospital were collected and divided into gastric perforation (GP) group and duodenal perforation (DP) group. Demographics, clinical events, etiological factors, symptoms, the time from symptom onset to operation, intraoperative findings and surgical procedures were analyzed. Read More

Tunis Med 2018 Jul;96(7):424-429

Background: Laparoscopic surgery has become the gold standard for many procedures owing to its advantages such as a shorter post-operative stay, a faster recovery and less postoperative pain. However, choosing laparoscopic approach in an emergency situationsuch as in the management of a perforated duodenal peptic ulcer is still debated because of the absence of significant benefits. This study aimed to assess the management of perforated duodenal peptic ulcer treated by suture. Read More

J Laparoendosc Adv Surg Tech A 2019 Feb 23;29(2):248-255. Epub 2018 Oct 23.

1 Division of Pediatric Surgery, Department of Surgery, Saint Louis University School of Medicine , Saint Louis, Missouri.

Introduction: Peptic ulcer disease (PUD) is a rare condition in children. Perforated peptic ulcer (PPU), a complication of PUD has an estimated mortality between 1.3% and 20%. Read More

J Clin Med 2018 Oct 12;7(10). Epub 2018 Oct 12.

Division of Plastic Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.

Background: The purpose of this study was to profile the bacterium in the ascites and blood of patients with acute surgical abdomen by metagenome analysis.

Methods: A total of 97 patients with acute surgical abdomen were included in this study. Accompanied with the standard culture procedures, ascites and blood samples were collected for metagenome analysis to measure the relative abundance of bacteria among groups of patients and between blood and ascites. Read More

Surg Laparosc Endosc Percutan Tech 2018 Dec;28(6):410-415

Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Orange.

Background: Perforated peptic ulcer (PPU) surgery mortality ranges 1% to 24%. We hypothesized a decrease in length of stay (LOS) with laparoscopic surgical repair (LSR) compared with open surgical repair (OSR).

Methods: Patients undergoing PPU surgery 2005 to 2015 were identified in NSQIP. Read More

Surg Infect (Larchmt) 2019 Jan 9;20(1):10-15. Epub 2018 Oct 9.

1 Department of Surgery, Washington University in St. Louis , St. Louis, Missouri.

Background: Clostridium difficile infection (CDI) is an important surgical complication. Emergency general surgery (EGS) is a developing area of the acute care surgical practice. Few studies evaluating the incidence and risk factors of CDI in this patient population are available. Read More

Am Surg 2018 Sep;84(9):1466-1469

Patients with end stage renal disease (ESRD) represent a growing subset of surgical candidates and ESRD status has been associated with increased morbidity and mortality in other operations. Using a national database, we examined outcomes and risk factors for patients presenting with perforated gastroduodenal ulcers undergoing omentopexy. We identified adult and emergent patients with perforated duodenal and gastroduodenal ulcers that underwent omentopexy using the 2005 to 2012 Nationwide Inpatient Sample. Read More

BMC Surg 2018 Sep 25;18(1):78. Epub 2018 Sep 25.

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Background: Perforated peptic ulcers (PPU) remain one of the most frequent causes of death. Their incidence are largely unchanged accounting for 2-4% of peptic ulcers and remain the second most frequent abdominal cause of perforation and of indication for gastric emergency surgery. The minimally invasive approach has been proposed to treat PPU however some concerns on the offered advantages remain. Read More

Surg Clin North Am 2018 Oct;98(5):933-944

Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.

The management of peptic ulcer disease has radically changed over the last 40 years from primarily surgical treatment to medical therapy nearly eliminating the need for elective surgery in these patients. Although there has been a decline in patients requiring acute surgical intervention for complications of peptic ulcer disease (perforation, bleeding, and obstruction), these patients still make up a significant proportion of hospital admissions every year. The modern acute care surgeon must have significant knowledge of the multiple treatment modalities used to appropriately care for these patients. Read More

Internist (Berl) 2019 Mar;60(3):298-303

Institut für Pathologie Bonn-Duisdorf, Bonn, Deutschland.

Duodenal ulcers are most often caused by Helicobacter pylori (HP) infection, followed by nonsteroidal anti-inflammatory drugs and hypoperfusion. Posttransplant lymphoproliferative disorder (PTLD) occurs in about 1-6.3% of patients with a heart transplant under immunosuppression therapy. Read More

Mo Med 2018 May-Jun;115(3):219-224

Elizabeth Marsicano, MD, is an Assistant Professor of Internal Medicine in the Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, Mo.

Peptic ulcer disease (PUD) is a common condition that both primary care providers and gastroenterologists encounter. Symptoms of peptic ulcer disease are variable and may include abdominal pain, nausea, vomiting, weight loss and bleeding or perforation with complicated disease. Identifying the risk factors and mechanisms that lead to the development of PUD helps to understand the approach behind diagnostic and treatment strategies. Read More

Am J Surg 2018 Dec 7;216(6):1127-1128. Epub 2018 Sep 7.

Division of Trauma, Burns, and Surgical Critical Care, Brigham and Women's Hospital, Boston, MA, USA.

Background: While advances in diagnosis and treatment of peptic ulcer disease have led to a decrease in hospital admissions the socioeconomic distribution of these benefits is unknown.

Methods: We designed a retrospective cohort study using the National Inpatient Sample from 2012 to 2013 including all patients that were admitted for peptic ulcer disease. We compared the types of ulcer related complications, the rates of intervention and the outcomes based on race and insurance status. Read More

Surgery 2018 Nov 31;164(5):1109-1116. Epub 2018 Aug 31.

Center for Surgery and Public Health, Brigham & Women's Hospital, Boston, MA; Department of Surgery, Brigham & Women's Hospital, Boston, MA.

Background: Hospital-level variation has been found to influence outcomes in emergency general surgery. However, whether the individual surgeon plays a role in this variation is unknown.

Methods: We performed an analysis of the Florida State Inpatient Database (2010-2014), which is linked to the American Hospital Association's Annual Survey Database, including patients who emergently underwent 1 or more of 7 procedures (laparotomy, adhesiolysis, small bowel resection, colectomy, repair of a perforated gastric ulcer, appendectomy, or cholecystectomy). Read More

BMJ Open 2018 Aug 20;8(8):e023721. Epub 2018 Aug 20.

Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Objectives: This study used national audit data to describe current management and outcomes of patients undergoing surgery for complications of peptic ulcer disease (PUD), including perforation and bleeding. It was also planned to explore factors associated with fatal outcome after surgery for perforated ulcers. These analyses were designed to provide a thorough understanding of current practice and identify potentially modifiable factors associated with outcome as targets for future quality improvement. Read More

Surgery 2018 10 4;164(4):738-745. Epub 2018 Aug 4.

Department of Surgery, Pietermaritzburg Metropolitan Complex, University of Kwa-Zulu Natal, South Africa. Electronic address:

Introduction: Perforated peptic ulcer disease (PPUD) including both duodenl and gastric ulcers is a severe disease and outcomes are influenced by comorbidities and physiology. We validated the AAST EGS grading system at two diverse centers (Mayo Clinic, USA and Pietermaritzburg, South Africa).

Methods: Dual-center review of historic data (2010-2016) of adults with PPUD was performed. Read More

Am Surg 2018 Jul;84(7):1204-1206

The number of patients being treated surgically for gastroduodenal disease has decreased over the past five decades as a result of focus on medical treatment. However, perforated and bleeding peptic ulcer disease (PUD) continues to represent a significant percentage of patients who require emergency surgery. The aim of this study was to characterize these critically ill surgical patients treated for gastroduodenal disease in our hospital. Read More

Surg Endosc 2019 Jan 24;33(1):281-292. Epub 2018 Jul 24.

Department of Surgery, University of Minnesota, Minneapolis, USA.

Introduction: Perforated peptic ulcers are a surgical emergency that can be repaired using either laparoscopic surgery (LS) or open surgery (OS). No consensus has been reached on the comparative outcomes and safety of each approach.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, we conducted a 12-year retrospective review (2005-2016) and identified 6260 adult patients who underwent either LS (n = 616) or OS (n = 5644) to repair perforated peptic ulcers. Read More

Surg Infect (Larchmt) 2018 Aug/Sep;19(6):587-592. Epub 2018 Jul 23.

1 Department of Surgery, Washington University in St Louis , St. Louis, Missouri.

Background: With the advent of anti-Helicobacter pylori therapy, hospital admissions for peptic ulcer disease (PUD) have declined significantly since the 1990s. Despite this, operative treatment of PUD still is common. Although previous papers suggest that Candida in peritoneal fluid cultures may be associated with worse outcomes in patients with perforated peptic ulcers (PPUs), post-operative anti-fungal therapy has not been effective. Read More

Surg Endosc 2018 Sep 19;32(9):3783-3788. Epub 2018 Jul 19.

Department of Surgery & Cancer, Imperial College London, London, UK.

Background: Randomized controlled trials have shown that laparoscopic approach to surgery for perforated peptic ulcer (PPU) is associated with improved short-term outcomes; however, there is limited evidence concerning national practice. The aim of this investigation was to evaluate the effect of laparoscopic approach to PPU surgery upon mortality and morbidity in England.

Methods: Patients with a primary diagnosis of PPU, admitted as an emergency to a hospital in England, and receiving surgical intervention, between 2005 and 2012 were identified from the Hospital Episode Statistics database. Read More

Am J Surg 2019 Jan 2;217(1):121-125. Epub 2018 Jul 2.

Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Background: An association between lack of insurance and inferior outcomes has been well described for a number of surgical emergencies, yet little is known about the relationship of payor status and outcomes of patients undergoing emergent surgical repair for upper gastrointestinal (UGI) perforations. We evaluated the association of payor status and in-hospital mortality for patients undergoing emergency surgery for UGI perforations in the United States.

Methods: Nationwide Inpatient Sample (NIS) was queried to identify patients between 18 and 64 years of age who underwent emergent (open or laparoscopic) repair for UGI perforations secondary to peptic ulcer disease (2010-2014). Read More

Surg Endosc 2019 Mar 11;33(3):764-772. Epub 2018 Jul 11.

Department of Surgery, University of Kentucky, 800 Rose Street, MN274, Lexington, KY, 40536-0298, USA.

Background: We compared 30-day outcomes in patients undergoing emergent open and laparoscopic repair of perforated peptic ulcers in a large multicenter cohort.

Methods: Prospectively obtained data in the American College of Surgeons National Surgical Quality Improvement Program public use files from 2010 to 2016 were reviewed. Perioperative risks and outcomes were compared in unmatched and propensity-matched groups using parametric/non-parametric statistical tests as appropriate. Read More

Medicine (Baltimore) 2018 Jul;97(28):e11323

Service de réanimation polyvalente.

Rationale: Very few cases of secondary peritonitis caused by Streptococcus pneumoniae have been described in the literature, and they have been found to occur mostly in patients with predisposing factors. Here, we report the case of an elderly patient who developed pneumococcal peritonitis secondary to perforation of gastroduodenal ulcer.

Patient Concerns: An 82-year-old man was admitted to intensive care unit (ICU) for septic shock with cardiac impairment 1 day after arriving in the Emergency Department. Read More

Khirurgiia (Mosk) 2018(6):58-61

Department of Surgery and Endoscopy Faculty of Additional Professional Education, Pirogov Russian National Research Medical University, Moscow, Russia, Buyanov Municipal Clinical Hospital of Moscow Healthcare Department, Moscow, Russia.

Aim: To analyze the outcomes of fast track rehabilitation program in patients with perforated duodenal ulcer (PDU).

Material And Methods: For the period 2013-2016 at the Department of Surgery and Endoscopy 206 PDU patients have been treated. Inclusion criterion for the main group (n=77) was duodenal ulcers, their dimension up to 1 cm, laparoscopic suture of perforated ulcer, fast track rehabilitation program implementation. Read More

Clin Pract Cases Emerg Med 2017 Aug 9;1(3):179-182. Epub 2017 May 9.

Kern Medical, Department of Emergency Medicine, Bakersfield, CA.

Acute myocardial infarction and perforated peptic ulcer disease with associated peritonitis are both medical emergencies requiring urgent intervention. This patient presented with both emergencies simultaneously. Current literature is devoid of guidance as to which should be addressed initially. Read More

J Clin Endocrinol Metab 2018 08;103(8):2811-2814

Diabetes, Obesity and Endocrinology Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.

Context: Patients taking exogenous glucocorticoids are at risk for gastrointestinal (GI) complications, including peptic ulcer disease with perforation and gastric bleeding. However, little is known about the GI comorbidity in patients with endogenous hypercortisolemia.

Case Descriptions: We describe six patients with endogenous Cushing syndrome (CS) who developed sudden perforation of colonic diverticula necessitating urgent exploratory laparotomy. Read More

Asian J Endosc Surg 2019 Apr 27;12(2):139-144. Epub 2018 May 27.

Department of Upper Gastrointestinal/Hepatopancreaticobiliary Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.

Introduction: Perforated peptic ulcer disease (PPU) is a condition subject to wide geographical variations in incidence. It remains a significant cause of morbidity and mortality, even in the era of Helicobacter pylori eradication and proton-pump inhibitor therapy. There is no clear consensus on whether laparoscopic or open approaches are superior, and with most studies in this area originating from Europe and Asia, Australian data addressing this issue are lacking. Read More

Am J Case Rep 2018 May 4;19:527-533. Epub 2018 May 4.

Department of Pathology, Al-Amiri Hospital, Kuwait City, Kuwait.

BACKGROUND Spontaneous gastric perforation is usually a complication of peptic ulcer disease, or a postoperative complication resulting from gastric torsion. Mucormycosis (or zygomycosis) is an uncommon opportunistic fungal infection that is usually seen in immunocompromised patients and is associated with significant morbidity and mortality. This report is of a rare case of spontaneous gastric perforation due to mucormycosis infection. Read More

Am J Emerg Med 2018 Aug 25;36(8):1525.e1-1525.e3. Epub 2018 Apr 25.

Clinic for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address:

Even though the incidence of complicated peptic ulcer disease (PUD) has decreased in the last decades, it remains a condition with a significant mortality. Whilst diagnosis and treatment of PUD in morbidly obese patients can be challenging, patients with excluded segments - such as after Roux-Y Gastric Bypass (RYGB) - present an even greater problem, as the subsequent altered anatomy impedes the common modalities used for diagnostic and therapeutic measures. We report the cases of two patients after RYGB with perforated duodenal ulcers in the intention to highlight problems regarding diagnosis and treatment. Read More

J Trauma Acute Care Surg 2018 08;85(2):417-425

From the Department of General and Oncologic Surgery, University of Perugia, Terni, Italy (R.C, E.R.); University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK (K.S.); Emergency Surgery and Trauma Surgery Unit, Maggiore Hospital Trauma Center, Bologna, Italy (S.D.S.); Department of Surgical Sciences (A.A.), University of Turin, Turin, Italy; Department of General Surgery (M.Z.), Policlinico San Pietro, Ponte San Pietro, Italy; Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy (I.A.); Department of Surgery (N.V.), Montichiari Hospital, ASST Spedali Civili Brescia, Brescia, Italy; Emergency Surgery Unit, Cisanello Hospital, University of Pisa, Pisa, Italy (M.C.); Department of Gastrointestinal Surgery (K.S.), Stavanger University Hospital, Stavanger, Norway; and Department of Clinical Medicine (K.S.), University of Bergen, Bergen, Norway.

Background: Surgery is the treatment of choice for perforated peptic ulcer disease. The aim of the present review was to compare the perioperative outcomes of acute laparoscopic versus open repair for peptic ulcer disease.

Methods: A systematic literature search was performed for randomized controlled trials (RCTs) published in PubMed, SCOPUS, and Web of Science. Read More

Cureus 2018 Feb 5;10(2):e2160. Epub 2018 Feb 5.

College of Medicine, Texas A&M College of Medicine.

Delayed splenic rupture, once thought to be unusual, but now growing in incidence, is an issue that could potentiate severe morbidity and mortality to patients, regardless of the severity of the trauma. This case report presents one instance of delayed splenic rupture following minor trauma and discusses the need for further investigation in the management of this condition. A middle-aged, hypotensive male presented to the emergency department (ED) with signs of an acute abdomen following a syncopal episode, with successful resuscitation upon arrival. Read More

BMJ Case Rep 2018 Apr 5;2018. Epub 2018 Apr 5.

Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA.

Ulcer perforation in the excluded stomach and duodenum is a rare complication after Roux-en-Y gastric bypass (RYGB). Pathogenesis of these ulcers are multifactorial. We report a case of perforated gastric remnant ulcer in a 54-year-old woman who had undergone a laparoscopic RYGB 5 years previously. Read More

Scand J Trauma Resusc Emerg Med 2018 Apr 5;26(1):25. Epub 2018 Apr 5.

Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.

Background: Triage systems are used in emergency medical services to systematically prioritize prehospital resources according to individual patient conditions. Previous studies have shown cases of preventable deaths in emergency medical services even when triage systems are used, indicating a potential undertriage among some conditions. The aim of this study was to investigate the triage level among patients diagnosed with perforated peptic ulcer (PPU) or peptic ulcer bleeding (PUB). Read More