Combination of duodenal ulcer perforation along with bleeding, penetration and stenosis

D. M. Kadyrov, Z. V. Tabarov, F. D. Kodirov, S. S. Saidaliev
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Abstract

This article considers a clinical case of a combination of four complications of duodenal ulcer. Against the background of chronic complications of penetrating ulcer and decompensated duodenostenosis, two acute complications were simultaneously observed - perforation of the ulcer and bleeding from it into the lumen of the GI tract and abdominal cavity. A prolonged course of the disease and the absence of timely surgical treatment of penetrating stenotic ulcer were the reasons for the simultaneous development of two acute complications of duodenal ulcer. Against the background of the severe general condition of the patient, caused by decompensated stenosis with profound homeostasis disorders, alimentary dystrophy, widespread purulent-fibrinous peritonitis and hemoperitoneum, suturing of the perforating ulcer was a necessary operation. At the second stage, it is recommended to perform radical surgery as a planned procedure. 
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十二指肠溃疡穿孔伴出血、渗透及狭窄
本文报道一例十二指肠溃疡合并四种并发症的临床病例。以穿透性溃疡和失代偿性十二指肠狭窄为慢性并发症为背景,同时观察到溃疡穿孔和出血进入胃肠道和腹腔两种急性并发症。病程延长及穿透性狭窄性溃疡手术治疗不及时是十二指肠溃疡两种急性并发症同时发生的原因。鉴于该患者一般情况严重,包括失代偿性狭窄伴严重体内平衡紊乱、消化不良、广泛的脓纤维性腹膜炎和腹膜出血,缝合穿孔溃疡是必要的手术。在第二阶段,建议将根治性手术作为计划手术。
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