Tung-Yi Lin1, Yu-Chun Chuang2, Fu-Cheng Kao3, Chiu Ping-Yeh3, Tsung-Ting Tsai3, Tsai-Sheng Fu2, Po-Liang Lai3. 1. Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung branch, and Chang Gung University College of Medicine, Taoyuan, Taiwan, No. 222 Mai-King Road, Keelung, Taiwan. ross_1222@hotmail.com. 2. Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung branch, and Chang Gung University College of Medicine, Taoyuan, Taiwan, No. 222 Mai-King Road, Keelung, Taiwan. 3. Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou branch, and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Abstract
BACKGROUND: To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgery. METHODS: Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed. RESULTS: Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressively worsening. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer. CONCLUSION: Spine surgeons should be highly alert to these risk factors of postoperative perforated peptic ulcers inpatients who has history of peptic ulcer, large amount ofintraoperative blood loss and abnormal high serum amylase level after elective spine surgery. Early diagnosis and emergent surgical intervention promote better outcomes.
BACKGROUND: To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgery. METHODS:Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed. RESULTS: Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressively worsening. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer. CONCLUSION: Spine surgeons should be highly alert to these risk factors of postoperative perforated peptic ulcers inpatients who has history of peptic ulcer, large amount ofintraoperative blood loss and abnormal high serum amylase level after elective spine surgery. Early diagnosis and emergent surgical intervention promote better outcomes.
Entities:
Keywords:
Abdominal pain; Perforated peptic ulcer; Postoperative; Spine surgery