SurgeNote

سامحوني حننقطع عنكم هاليومين 🥱

“POMM” → Perforation, Obstruction, Malignancy, Miscellaneous (fistula, chronic bleeding)

انا اخترت B

A 30 years old male presented with massive hematemesis. A 2 × 2 cm ulcer was visualized on upper GI endoscopy on the posterior aspect of first part of duodenum. The bleeding vessel was visualized but bleeding could not be controlled endoscopically. Blood transfusion was done and patient was planned for surgery. His BP was 90/70 and PR=110/min with Hb=9 gm% at the time of surgery.

“BURN at NIGHT, FOOD RELIEVES” B → Burning epigastric pain U → Usually nocturnal (wakes patient) R → Radiates to back (posterior ulcers) N → Nocturnal pain FOOD RELIEVES → Pain relieved by meals or antacids

11. A thirty years old male presents to the emergency department with symptoms of epigastric pain radiating to back that wakes him up at night and is relieved by consuming food. He gives history of similar pain in the past which was diagnosed as perforated duodenal ulcer and treated with omental patch surgery on two occasions. Pain before and after surgery has been controlled with proton pump inhibitors and analgesics.

“Duodenal ulcers: bulb, H. pylori, rare malignancy, recurrence drops after eradication”

توا مش اسئلتي مفيدة تستفاد معلومة وتختبر قرايتك 🥱❤

With reference to duodenal ulcers, consider the following statements: 1. They occur most often in the second part of duodenum. 2. Infection with H. pylori and NSAID - induces injury account for majority of duodenal ulcer. 3. Malignant duodenal ulcers are extremely rare. 4. Eradication of H. pylori has greatly reduced the recurrence rates in duodenal ulcers.