[Preoperative preparation and postoperative care in perforated gastric ulcer].
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SUMMARY: Although 41% of patients with spontaneous rupture of the esophagus also suffer from gastro duodenal ulcer disease, cases of synchronous spontaneous esophageal and duodenal ulcer perforation have thus far not been reported in the literature. We report on the case of a 61-year-old man who presented with a 72-hour history of esophageal rupture and duodenal ulcer perforation. Following appropriate circulatory resuscitation we performed double resection; involving the esophagus, cardia and the distal part of the stomach, followed by substitution by means of gastro-jejunal transposition as a one-stage procedure. With reference to this case with a favorable outcome, we are presenting an analysis of indications for resectional surgery in advanced spontaneous esophageal perforation.
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Both spontaneous esophageal perforations (Boerhaave syndrome) and duodenal ulcer perforations are medical emergencies. Spontaneous esophageal perforation (SEP) is the most serious and rapidly lethal perforation of the gastrointestinal tract. Prompt diagnosis and early therapy is needed to prevent death and prolonged serious illness, and the key to the diagnosis is an awareness of its frequent atypical presentations. This article presents a case report of SEP and duodenal ulcer perforation which caused a right-sided subpulmonic abscess and reviews the literature pertaining to this subject.
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