Peptic ulcer
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Transcript of Peptic ulcer
SURGICAL MANAGMENT OF
BYDr. Pirah Korai
FCPS-ii TRAINEECMC LARKANA
OUTLINES
Introduction
Diagnosis
Medical management
Surgical management
DIAGNOSIS
UGIS (Double contrast studies)
Endoscopy
MANAGMENT
Conservative
Regular lifestyle
Prohibition of the smoking and alcohol
Diet (proteins, milk and milky products)
MEDICAL OPTIONS
Antacids
Anticholinergics
H2 Blockers
PPIs
SURGICAL MANAGMENT
INDICATIONS
Intractable ulcers
Life threatening complications of ulcer (e.g bleeding, perforation, obstruction)
DUODENAL ULCER
Billroth ll Gastrectomy
Gastrojejunostomy
Truncul vagotomy and drainage
Higly selective vagotomy
Truncul vagotomy and antrectomy
Billroth ll operation
Billroth l Gastrectomy
COMPLICATIONS
Recurrent ulcerationSmall stomach syndromeBile vomitingEarly dumpinglate dumpingPostvagotomy diarrheaMalignant transformationNutritional consequencesGall stones
COMPLICATED PEPTIC ULCER