9. Surgical aspects of peptic ulcer disease

Question 1

Most common causes

Answer 1

• H. Pylorii
• Chronic NSAID use
• Alcohol and smoking are risk factors

Question 2

Diagnosis

Answer 2

• Upper endoscopy w/ biopsy

- Urea breath test - H. pylorii specific

Question 3

Complications

Answer 3

• Perforation into peritoneal cavity; infection -> sepsis
• Can reach vital arteries if it digs deep; shock
• Scar tissue formation can block pyloric sphincter and cause nausea and vomiting (PYLORIC STENOSIS)

Question 4

Non surgical treatments

Answer 4

• H. pylorii - antibiotics
• Chronic NSAID use - stop taking NSAIDS LMAO
• Lifestyle changes (quit smoking, drinking etc)

Question 5

Surgeries

Answer 5

• Vagotomy (truncal, selective, superselective): not
  really used today, only if triple therapy fails
• Resection of the stomach
  • Billroth-1
  • Billroth-2

Question 6

Treatment of pyloric stenosis

Answer 6

Pyloroplasty