Update on the pathophysiology, diagnosis and treatment of peptic ulcer disease
Keywords:
PEPTIC ULCER, PECTIC ULCER PERFORATION, RISK FACTORS.Abstract
Introduction: perforated peptic ulcer is an entity of great medical importance due to the risks it poses to the patient's life.
Objective: to describe the pathophysiology, diagnosis and treatment of perforated peptic ulcer.
Methods: a search for information was carried out in the PubMed/MEDLINE, SciELO and Scopus databases. Articles in Spanish and English were selected, leaving 37 bibliographic references for the present review.
Development: Peptic ulcer is a breach or rupture that appears in the stomach walls, in the duodenum, and occasionally in the lower esophagus; it can also occur in the upper part of the jejunum. Among the etiological factors of this disease are Helicobacter pylori infection, consumption of non-steroidal anti-inflammatory drugs, gastric hypersecretion, diseases of the gastroduodenal mucosa itself, stress, a highly seasoned diet, toxic habits, as well as genetic factors and family history. The diagnosis of perforated peptic ulcer is made clinically. Treatment is based on medical (histamine receptor antagonists and proton pump inhibitors) and surgical treatment.
Conclusion: peptic ulcer is a multifactorial disease, influenced by lifestyle, dietary habits, drug consumption and stress, among other factors. Treatment can be medical, in simple cases, or surgical, in the presence of peptic ulcer.
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References
2. Gamboa-Molina L, Molina-Raad V. Insuficiente producción bibliográfica sobre úlcera péptica perforada en la revista médica de Las Tunas. Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta [Internet]. 2018 [citado 20/12/19]; 43(3). Disponible en: http://www.revzoilomarinello.sld.cu/index.php/zmv/article/view/1282
3. Boyd-Carson H, Doleman B, Cromwell D. Delay in Source Control in Perforated Peptic Ulcer Leads to 6 % Increased Risk of Death Per Hour: A Nationwide Cohort Study. World Journal of Surgery [Internet]. 2019 [citado 20/12/19]; 44(3): 869-875. Disponible en: https://doi.org/10.1007/s00268-019-05254-x
4. Rasane RK, Horn CB, Coleoglou Centeno AA. Are Patients with Perforated Peptic Ulcers Who are Negative for Helicobacter pylori at a Greater Risk? Surgical Infections [Internet]. 2019 [citado 20/12/19]; 20(6): 444-8. Disponible en: https://www.liebertpub.com/doi/abs/10.1089/sur.2018.249
5. Cintra Brooks S, Cintra Pérez A, Cintra Pérez S. Úlcera gastroduodenal perforada en el Hospital “Dr Agostinho Neto” de Guantánamo. Estudio de 10 años. Rev Inf Cient [Internet]. 2016 [citado 20/12/19]; 95(1):127-138. Disponible en: http://revgmespirituana.sld.cu/index.php/gme/article/view/787/626
6. Zuluaga-Arbeláez N, Uribe-Castaño S, Machado-Rivera FA. Síndrome de Valentino: úlcera péptica perforada simulando apendicitis aguda. Rev CES Med [Internet]. 2018 [citado 20/12/19]; 32(2): 74-8. Disponible en: http://www.scielo.org.co/pdf/cesm/v32n1/0120-8705-cesm-32-01-00074.pdf
7. Ramírez-Ramírez MM, Villanueva-Saenz E. Síndrome de Valentino. Úlcera péptica perforada con presentación clínica inusual. Rev Gastroent México [Internet]. 2016 [citado 20/12/19]; 81(4): 225-6. Disponible en: https://reader.elsevier.com/reader/sd/pii/S0375090616300271
8. Kyle RA, Steensma DP, Shampo MA. Barry James Marshall – Discovery of Helicobacter pylori as a Cause of Peptic Ulcer. Mayo Clinic Proceedings [Internet]. 2016 [citado 20/12/19]; 91(5): e67-e68. Disponible en: https://www.mayoclinicproceedings.org/article/S0025-6196(16)30032-5/pdf
9. Grzybowski A, Sak J. Jan Mikulicz-Radecki (1850-1905): His impact on modern medicine. Clinics in Dermatology [Internet]. 2012 [citado 20/12/19]; 30(1): 129-36. Disponible en: https://www.researchgate.net/publication/257243948_Jan_Mikulicz-Radecki_1850-1905_His_impact_on_modern_medicine/link/5c94a3aa299bf111693eb2dd/download
10. Bejerano García RJ. Perforación gastroduodenal por ulcera péptica: estudio de 99 pacientes operados. Revista Cubana de Cirugía [Internet]. 2007 [citado 20/12/19]; 46(3). Disponible en: http://scielo.sld.cu/scielo.php?pid=s0034-74932007000300006&script=sci_arttext&tlng=en
11. Chaudhry SR, Liman MNP, Peterson DC. Anatomy, Abdomen and Pelvis, Stomach. StatPearls Publishing [Internet]. StatPearls; 2022 [citado 20/12/19]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK482334/
12. Lopez PP, Gogna S, Khorasani-Zadeh A. Anatomy, Abdomen and Pelvis, Duodenum. StatPearls Publishing [Internet]. StatPearls; 2023 [citado 20/12/19]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK482390/
13. Chung KT, Shelat VG. Perforated peptic ulcer - an update. World J Gastrointest Surg [Internet]. 2017 [citado 20/12/19]; 9(1):1. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237817/
14. Flores Miranda E, Flores Delgado EA. Resultados del tratamiento de la úlcera péptica perforada. Revista Cubana de Cirugía [Internet]. 2009 [citado 20/12/19]; 48(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932009000200005
15. Cabrera Cárdenas FA, Hidalgo Herrera M, Lorda Galiano L. Comportamiento de la úlcera gastroduodenal perforada. Revista Cubana de Medicina Militar [Internet]. 2011 [citado 20/12/19]; 40(1): 12-21. Disponible en: http://scielo.sld.cu/scielo.php?pid=S0138-65572011000100003&script=sci_arttext&tlng=pt
16. Stern E, Sugumar K, Journey JD. Peptic Ulcer Perforated. StatPearls Publishing LLC [Internet]. StatPearls; 2019 [citado 20/12/19]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK538326/
17. Jonson C, Malean R, McCallum I, Phillips AW. Perforated duodenal ulcers: Changes in management and outcomes [Internet]. NHS; 2019 [citado 20/12/19]. Disponible en: https://nogu.org.uk/wp-content/uploads/2019/09/Perforated-duodenal-ulcers.pdf
18. Khan S, Gupta OP. Surgical outcome of management of perforated peptic ulcer: retrospective analysis of 148 cases. Int Surg J [Internet]. 2019 [citado 20/12/19]; 6(10): 3643-9. Disponible en: http://dx.doi.org/10.18203/2349-2902.isj20194418
19. Romero Barrientos C, Castellanos Garden L, Fuentecilla Jiménez S, García Díaz M, Pérez Villalón E. Caracterización clínico-epidemiológica de pacientes ingresados con úlcera péptica. Revista Información Científica [Internet]. 2016 [citado 20/12/19]; 95(5): 683‐691. Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/48/2133
20. Sarda DK, Garg PK. Study of Incidence of Peptic Ulcer Perforation in Young Adults: A Hospital Based Study. International Archives of BioMedical and Clinical Research [Internet]. 2018 [citado 20/12/19]; 4(1): 120-3. Disponible en: https://iabcr.org/index.php/iabcr/article/view/508
21. Flores Miranda E, Sánchez Brizuela JA, Flores Delgado EA. Eficacia de sutura y epiploplastia con tratamiento médico posterior en la úlcera perforada. Revista Cubana de Cirugía [Internet]. 2016 [citado 20/12/19]; 55(3): 201-10. Disponible en: http://scielo.sld.cu/scielo.php?pid=S0034-74932016000300002&script=sci_arttext&tlng=en
22. Chao-Wen P, Li-Ren L, Fan-Yun M, Min-Jen T, Guo-Shiou L. Simple laparoscopic repair of perforated peptic ulcer without omental match. Asian Journal of Surgery [Internet]. 2020 [citado 20/2/2020]; 43(1): 311-4. Disponible en: https://www.sciencedirect.com/science/article/pii/S1015958419307869
23. Gómez Triana JM, Gallego Díaz BJ, Odales Ibarra R, Aquino Pérez L. Resultados del tratamiento de la úlcera gastroduodenal perforada. Estudio en 10 años. Gaceta Médica Espirituana [Internet]. 2007 [citado 20/12/19]; 9(2): 7. Disponible en: http://revgmespirituana.sld.cu/index.php/gme/article/view/787/626
24. Armas Pérez B, Reyes Balseiro E, García Rodríguez M, Armas Moredo K. Cirugía exerética en la úlcera péptica complicada: ¿procedimiento extemporáneo? Revista Cubana de Cirugía [Internet]. 2010 [citado 20/12/19]; 49(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932010000100002
25. Rodríguez-Espínola G, Trejo-Ávila ME, Valenzuela-Salazar C, Solórzano-Vicuña D, Romero-Loera LS, Moreno-Portillo M. Tratamiento mínimamente invasivo de úlceras pépticas perforadas en el Hospital General “Dr. Manuel Gea González”. Cirujano General [Internet]. 2016 [citado 20/12/19]; 38(2): 72-7. Disponible en: https://www.medigraphic.com/pdfs/cirgen/cg-2016/cg162d.pdf
26. Molina Raad V, Agüero Batista NN. Redefinir el concepto de método clínico: una necesidad de la práctica médica contemporánea. Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta [Internet]. 2016 [citado 20/12/19]; 41(1). Disponible en: http://revzoilomarinello.sld.cu/index.php/zmv/article/view /558
27. Soler Vaillant R, Mederos Curbelo ON. Cirugía. Tomo II. Afecciones quirúrgicas frecuentes. La Habana: Editorial Ciencias Médicas; 2018.
28. Shashi SS, Hossain S, Bar D, Rahman A, Reza M, Harun-Ar-Rashid M. Outcome of Non-operative Management of Perforated Peptic Ulcer Disease. Journal of Surgical Sciences [Internet]. 2018 [citado 20/12/19]; 22(2): 95-98. Disponible en: http://www.sosbjournal.org/content/Vol%2022-No%202-July%202018/Outcome%20of%20Non-operative%20Management%20of%20Perforated%20Peptic%20Ulcer%20Disease.pdf
29. Søreide K, Thorsen K. Management of Perforated Peptic Ulcer. En: Di Saverio S, Catena F, Ansaloni L, Coccolini F, Velmahos G. (eds) Acute Care Surgery Handbook [Internet]. Springer, Cham; 2016 [citado 20/12/19]. Disponible en: https://doi.org/10.1007/978-3-319-15362-9_8
30. Mohan CP, Kabalimurthy J, Balamurugan E, Jayavarmaa R. A rare case of Valentino’s syndrome. International Surgery Journal [Internet]. 2018 [citado 20/12/19]; 5(8): 2933-5. Disponible en: https://ijsurgery.com/index.php/isj/article/view/3114/2256
31. Amann CJ, Austin AL, Rudinsky SL. Valentino’s Syndrome: A Life-Threatening Mimic of Acute Appendicitis. Clinical practice and cases in emergency medicine [Internet]. 2017 [citado 20/12/19]; 1(1): 44. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965439/
32. Ponsky JL, Strong AT. The Evolution of Management of Peptic Ulcer Disease. En: Grams J, Perry K, Tavakkoli A. (eds) The SAGES Manual of Foregut Surgery [Internet]. Springer; 2019 [citado 20/2/2020]. P.623-634. Disponible en: https://link.springer.com/chapter/10.1007/978-3-319-96122-4_52
33. Yuval JB, Szold A. Laparoscopic Repair of Perforated Peptic Ulcer. En: Bonjer H. (eds) Surgical Principles of Minimally Invasive Procedures [Internet]. Springer; 2017 [citado 20/2/2020]. P 71-73. Disponible en: https://doi.org/10.1007/978-3-319-43196-3_11
34. Vernon AH, Ferzoco SJ, Ashley SW. Surgical management of peptic ulcer disease [Internet]. UpToDate, Inc; 2019 [citado 20/12/19]. Disponible en: https://www.uptodate.com/contents/surgical-management-of-peptic-ulcer-disease
35. Mawla WA, Heggy IA, Osman G, Gertallah LM, Elgohary MN, Allam AS, et al. Surgical Management of Perforated Peptic Ulcer; Closure with Omental Patch versus Definitive Repair with Vagotomy and Gastrojejunostomy: A Comparative Study. Surgical Science [Internet]. 2019 [citado 20/12/19]; 10(09): 316-27. Disponible en: https://www.scirp.org/pdf/SS_2019092014590021.pdf
36. Rodríguez Pascual Y, Leyva Carralero CA, Vega Abascal L, Rodríguez García M, Pupo Zúñiga A. Comportamiento de la úlcera péptica perforada en pacientes atendidos en Cirugía del Hospital "V. I. Lenin". Correo Científico Médico [Internet]. 2008 [citado 20/12/19]; 12(1): 1. Disponible en: http://www.cocmed.sld.cu/no121/n121ori3.htm