Current status of peptic ulcer disease in Port Harcourt metropolis,Nigeria

BackgroundEpidemiological studies on peptic ulcer disease (PUD) have shown a recent decrease in hospital admissions in Western countries.ObjectiveThis paper aimed to study the current status and risk factors of PUD in a Nigerian metropolis.MethodsA cross-sectional study of symptomatic patients at upper gastrointestinal (GI) endoscopy diagnosed with PUD from February 2014 to September 2019 at a referral endoscopy facility in Port Harcourt, Niger delta region of Nigeria. The variables studied included demographics, symptoms and duration, blood group, chronic non-steroidal anti-inflammatory (NSAID) use, smoking, endoscopic and histology findings. Statistical analysis was performed using SPSS version 20.ResultsA total of 434 upper GI endoscopies were performed during the study period with thirty-one diagnosis of PUD made. The mean age of gastric ulcer (GU) and duodenal ulcer (DU) cases were 54.4 ± 20.2yrs and 48.1 ± 14.5yrs respectively (p = 0.367). GU to DU ratio was 1.4:1. H. pylori infection, chronic NSAID use and blood group O were seen in 7(22.5%), 8(25.8%) and 18(72.0%) respectively. Major indication in 21(67.7%) cases was gastrointestinal bleeding.ConclusionThere is a low diagnostic rate of PUD (6.7%) with pre-pyloric antral gastric ulcers as most common type and multifactorial aetiology.     

运动疲劳对大鼠十二指肠电活动的影响

本文报道了大鼠十二指肠电活动在运动疲劳前后的数值。结果表明：在运动疲劳后，快波、慢波振幅明显增加，而其频率却减少；Ⅰ相缩短，Ⅱ相延长，Ⅲ相、Ⅳ相及ＩＤＭＥＣ周期无显著变化；并在运动疲劳后９．７±２．４ｍｉｎ内出现不规律的食后型的电活动。这些改变可了解运动疲劳对消化系统的影响。     

Laparoscopic repair/peritoneal toilet of perforated duodenal ulcer

Summary Laparoscopic techniques have been refined to the point where exposure, haemostasis and tissue approximation by suture approach those obtained at open access surgery. We report a patient with acute perforation of an ulcer in the first part of the duodenum who was successfully treated by laparoscopic oversewing and omental patching. The clinical indications for contemplating use of laparoscopic surgery for acute ulcer perforation, techniques employed and the areas for potential improvement of instruments, needles and sutures are discussed.     

Biliopancreatic diversion with duodenal switch vs. gastric bypass for severe obesity

Conclusion In the year 2003 there is no “one best bariatric operation” for every severely obese patient. The choice of operation must be tailored to each individual patient’s needs and wishes. For the superobese patient, the patient diagnosed with intestinal metaplasia of the stomach, and for those patients who do not wish to undergo the severe dietary restrictions imposed by the RNY-GB, the BPD-DS is a valuable surgical option.     

十二指肠溃疡患者胃上皮化生与幽门螺杆菌关系的研究

目的 研究十二指肠溃疡患者胃上皮化生和幽门螺杆菌的关系。方法 收集门诊行上消化道胃镜检查确诊的十二指肠溃疡患者70例，另选胃和十二指肠黏膜正常患者55例为对照组。用快速尿素酶法和幽门活组织检查半定量法检测幽门螺杆菌(Hp)，苏木素一伊红染色和Schiff过碘酸染色半定量法检测十二指肠球部胃上皮化生。结果 十二指肠溃疡患者与对照组相比，十二指肠球部胃上皮化生检出率高；十二指肠球部胃上皮化生检出率和评分与胃幽门部Hp的检出率和评分无相关关系。结论 Hp不是十二指肠黏膜胃上皮化生的决定因素，也不是十二指肠黏膜胃上皮化生范围得以扩展的因素。十二指肠溃疡病本身的一些特点是十二指肠黏膜胃上皮化生的主要因素。     

ENDOSCOPIC MANAGEMENT OF A DIEULAFOY‐LIKE LESION IN A DUODENAL DIVERTICULUM

We present a 70‐year‐old man who had two episodes of melena during the preceding 8‐year period. He had a Dieulafoy‐like lesion in a diverticulum in the third portion of the duodenum. While emergency endoscopy revealed neither apparent blood nor clots around the diverticular orifice, there was a non‐bleeding vessel in the fundus of the diverticulum. The vessel ceased bleeding after argon plasma coagulation and, since then, the patient has not experienced bleeding. In cases of gastrointestinal bleeding of obscure origin, duodenal diverticulum should be considered as a possible source of bleeding, even when endoscopy discloses no apparent bleeding.     

舌形瓣溃疡贴壁缝合治疗难治性十二指肠后壁溃疡合并大出血

目的　探讨难以切除的十二指肠后壁溃疡合并大出血时的手术方式。方法　回顾性分析 4 7例难以切除的十二指肠后壁溃疡合并大出血时的临床资料。其中 35例为十二指肠球部溃疡 ,12例为球后溃疡。手术方式 :12例球后溃疡行Billroth Ⅱ式 ,35例球部溃疡行Bancroft术式 ,溃疡肠腔内旷置 ,十二指肠前壁部分做成舌形瓣与溃疡贴壁缝合。结果　 1例十二指肠漏 ,所有病例顺利康复。随访 9个月～ 5年无再出血。结论　该术式相对简单 ,创伤少 ,止血确切 ,并发症少 ,再出血率低 ,较为理想     

Primary aortoduodenal fistula caused by duodenal tuberculosis without an abdominal aortic aneurysm: Report of a case

A 66-year-old man died of massive gastrointestinal hemorrhage caused by a fistula between the third portion of the duodenum and the abdominal aorta. An autopsy revealed that duodenal tuberculosis had resulted in the development of a fistula into the aorta with no pathological changes, and no active pulmonary tuberculosis was found. Duodenal tuberculosis and primary aortoduodenal fistula (ADF) without an aneurysm are both extremely rare. Thus, we report herein a unique case of primary aortoduodenal fistula without an abdominal aortic aneurysm, but associated with duodenal tuberculosis, and review the current literature.     

埃索美拉唑三联与奥美拉唑三联疗法治疗Hp阳性十二指肠溃疡对比研究

目的比较埃索美拉唑三联与奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性十二指肠球部溃疡的临床疗效。方法将104例经内镜诊断并检测证实Hp阳性的十二指肠球部溃疡患者随机分为两组。埃索美拉唑组（52例）：埃索美托唑20mg＋阿莫西林1g＋克托霉素500mg，每日2次，共7d；奥美拉唑组（52例）：奥美拉唑20mg＋阿莫西林1g＋克拉霉素500mg，每日2次，共7d。疗程结束4周后复查胃镜并检测Hp，观察腹痛缓解率、溃疡愈合率、Hp根除率及用药后的不良反应等。结果埃索美拉唑组第1天和第2天腹痛缓解率分别为34．6％和59、6％，高于奥美托唑组的17.3％和38．5％（P〈0．05）。埃索美托唑组和奥美拉唑组溃疡愈合率分别为92.3％和88．5％，Hp根除率分别为88．5％和82．7％，差异无显著性（P〉0．05）。两组用药后不良反应少，有较好的安全性。结论埃索美拉唑三联疗法治疗Hp阳性的十二指肠溃疡安全有效．腹痛缓解速度优于奥美拉唑三联疗法。