The case of successful conservative treatment of gastriс fistula as one of the many complications of duodenal ulcer
DOI:
https://doi.org/10.11603/2414-4533.2017.2.7947Keywords:
complicated peptic ulcer, gastric fistula, conservative treatment.Abstract
The publication is based on the clinical examination of the patient M. during last six years. In 2010 46 years old patient was sent to the Center of acute pancreatitis with the diagnosis of severe acute pancreatitis. The patient was operated after 12 hours of the admission on the perforated duodenal ulcer with widespread peritonitis against the background of ulcerative stenosis of the duodenum. Suturing ulcers with superposition of anterior gastroenteroanastomosis was perfomed. Systematic treatment was not recieved. In February 2016, he entered the surgical department with a phlegmon of the anterior abdominal wall, the case of which was the penetrarion of ulcers of gastroenteroanastomosis into the anterior abdominal wall. By opening the phlegmon a gastric fistula was opened, which was closed against a background of intensive anti-inflammatory therapy and the use of large doses of pentacrasole.
In April 2016 the operation of resection of the stomac and Roux gastroenteroanastomosis were perfomed. Later the patient suffered three episodes of bleeding, they were stoped conservatively.
At the end of 2016 there were difficulties in swallowing food, stenosis in the oesophagus was diagnosed. It was treated in the thoracic department using bouginage and permeability was restored. Inspection in April 2017 – the patient has satisfactory condition, swallowing is free. At the FGD in the field of gastroenteroanastomosis recurrent u lcer was found.
The patient was offered hospital treatment in the department of gastroenterology and the examination for Zollinger-Ellison syndrome.
References
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