Bianco Agustín, Yaryura Montero José Gabriel, Gigena Agustín Ricardo, Petersen María Laura, Cafaro Mario Alberto, Cardenas Villa Roberto Dario, Traverso Rogelio Adrián
medico.
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Rev Fac Cien Med Univ Nac Cordoba. 2021 Jun 28;78(2):180-183. doi: 10.31053/1853.0605.v78.n2.29786.
Peptic ulcers are acid-induced lesions found in the stomach and duodenum. The prevalence of peptic ulcer disease in the United States is estimated to be 8.4%.
Describe an atypical presentation of complicated duodenal ulcer that causes jaundice and review the literature.
A 42-year-old male patient, who consulted for generalized jaundice and coluria, associated with low back pain treated with non-steroidal anti-inflammatory drugs. In the laboratory, total bilirubin increased to direct prevalence. A magnetic resonance cholangiography was performed that revealed duodenal thickening, with a decrease in its lumen; and a double contrast computed tomography, where thickening of the duodenal walls was observed, without oral contrast leakage. Subsequently, an upper digestive video-endoscopy was performed where a 30 mm duodenal bulb ulcer was observed. The patient presented good evolution with medical treatment, being discharged on the fifth day of hospitalization.
Jaundice can be caused by a duodenal ulcer that causes obstruction of the common bile duct. Medical treatment may specify in selected patients. In the present case, it was established to opt for medical treatment since the patient presented hemodynamic stability, without signs of generalized peritonitis, with complementary studies in favor of a contained duodenal ulcer without free air.
We are dealing with a case of duodenal ulcer complicated with jaundice that presented good evolution with medical treatment.
消化性溃疡是在胃和十二指肠发现的由酸引起的病变。据估计，美国消化性溃疡疾病的患病率为8.4%。
描述一例导致黄疸的复杂性十二指肠溃疡的非典型表现并复习相关文献。
一名42岁男性患者，因全身黄疸和血尿前来就诊，伴有腰痛，曾使用非甾体抗炎药治疗。实验室检查显示总胆红素升高至直接胆红素水平。进行了磁共振胆胰管造影，结果显示十二指肠增厚，管腔变窄；同时进行了双对比计算机断层扫描，观察到十二指肠壁增厚，无口服造影剂渗漏。随后进行了上消化道视频内镜检查，发现十二指肠球部有一个30毫米的溃疡。该患者经药物治疗后病情好转，住院第五天出院。
黄疸可能由导致胆总管梗阻的十二指肠溃疡引起。药物治疗可能适用于特定患者。在本病例中，由于患者血流动力学稳定，无全身腹膜炎体征，辅助检查支持为局限性十二指肠溃疡且无游离气体，因此决定选择药物治疗。
我们处理的是一例并发黄疸的十二指肠溃疡病例，经药物治疗后病情好转。
