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PubMed1996

Gastric ulcer perforation into the heart.

Penetration of the pericardium and heart is a very rare complication of benign peptic ulcer. The case is reported here of a 76-year-old woman with advanced senile dementia, who was admitted due to melena. Endoscopy revealed a large gastric ulcer located in a giant hiatal hernia. The ulcer base was protruding and strongly pulsatile, and seemed to be mobile and free in relation to the ulcer margins. This effect was particularly obvious during the pulsatile movements. Endoscopic findings suggested ulcer perforation to the pericardium. The patient's relatives denied consent to surgery. She was therefore treated with conservative measures, including parenteral nutrition, ranitidine, and antibiotics. The patient remained in a relatively stable condition, and she was discharged three weeks later. One month later, however, she was admitted with massive bleeding and hypovolemic shock. In spite of resuscitation measures, she died. The autopsy study showed a gastric ulcer penetrating through the pericardium and myocardium into the left ventricle.

Aged↗
PubMed1964

PEPTIC ULCER IN ASSAM.

Big differences in the prevalence of peptic ulcer are known to exist in different parts of India. This paper reports a high incidence in Assam and records certain differences with peptic ulcers found in south India.

Aging↗
PubMed2001

[Treatment of perforated gastroduodenal ulcers].

Results of treatment of 751 patients with perforated gastroduodenal ulcers are analyzed. In addition to routine tests, ultrasonography, computed tomography and laparoscopy were used to diagnose difficult cases. The optimum surgical aids are chosen by taking into account the interval between the onset of perforation and admission, a history of peptic ulcerous, the pattern of peritonitis, age, comorbidity, and surgical findings. Organ-saving operations with a vagotomy are preferable. 1% serotonin-adipinate (1 ml dissolved in 200 ml saline solution) was intravenously used to prevent early postvagotomic disorders (gastric atony, dynamic ileus, etc.) in the early postoperative period. Organ-saving operations with vagotomy were found to have some advantage over routine suturing.

Adult↗