Zil-E-Ali Ahsan, Bin Shafique Muhammad, Assad Salman, Ali Hammad, Ghani Usman
Surgery, Fatima Memorial Hospital.
Department of General Surgery, Postgraduate Trainee, Ghurki Trust Hospital, Lahore Medical & Dental College.
Cureus. 2016 Dec 1;8(12):e908. doi: 10.7759/cureus.908.
Surgical repair of perforated gastroduodenal ulcer has been extensively practiced in emergency clinical situations. Non-invasive conservation treatment is regaining the attention towards management of such ulcers. We report the case of a 50-year-old male smoker who presented in the emergency unit with acute generalized abdominal pain and guarding in the epigastric and right upper quadrant region. He is a known regular user of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) for more than 10 years for his osteoarthiritis and myalgias. A differential diagnosis of gastritis and duodenal perforation was made owing to the symptoms and long usage of NSAIDs. He was managed with an intravenous proton pump inhibitor and intravenous antibiotics. This therapy lead to stabilization of the clinical symptoms as well as laboratory and imaging studies.
胃十二指肠溃疡穿孔的手术修复在急诊临床情况下已广泛应用。非侵入性保守治疗正重新受到对此类溃疡治疗的关注。我们报告一例50岁男性吸烟者，他因急性全腹疼痛及上腹部和右上腹压痛就诊于急诊科。他因骨关节炎和肌痛规律服用非处方非甾体抗炎药（NSAIDs）超过10年。鉴于其症状及长期使用NSAIDs，做出了胃炎和十二指肠穿孔的鉴别诊断。给予他静脉注射质子泵抑制剂和静脉用抗生素治疗。该治疗使临床症状以及实验室和影像学检查结果趋于稳定。
