Surgical Treatment of Perforated Peptic Ulcer
In reality, a mere 5% of the cases of bleeding ulcers will be in need of operative management. When there will be a failure in achieving hemostatis endoscopically, there will be found some perforation that will be life threatening or there will be some recurrent bleeding in spite of the prior endoscopic attempts in trying to achieve hemostasis, the it will be indicated to follow up a urgent surgery. Many studies have show that perforated peptic ulcers may be treated nonoperatively, each one using several different indicators regarding surgery but having as common ground that a patient that will suffer from a perforated peptic ulcer has to undergo an exploratory laparotomy.
The operative versus the nonoperative approach has been highly debated in the medical field since the findings in the 1980s, many stating that a patient that will present such an illness but without having any evidence of pneumoperitoneum, will have high chances that the perforation will be sealed off on its own.
Treatment for such a situation will be the nonoperative approach due to the lower risks involved and the more effective results. Berne and Donovan has emphasized the fact that almost 40% of the perforated peptic ulcers will have no abdominal leak and will close by themselves, not needing a surgical procedure. But at the very same time these numbers seem a bit low when a person suffers from such an illness and many will not take such chances.
Depending on the doctor, the stage of the illness and the gravity of it, there are several treatments that can be applied but most of the medical field will not suggest any surgical procedures due to the high risk that it will involve.
There have been cases in which the patient suffered during the operation from a massive bleed and there where any other options. This illness will have very negative effects in your body that in time will lead so several other complications, perforated peptic ulcer being linked with other potentially life altering diseases.
Despite all the very strong arguments that were made against the operative form for the perforated peptic ulcer, if the patient will clearly need surgery and it will be delayed due to the insecurities and high risks involved, the state of that patient will worse in a maximum of twelve hours and the risks by them will increase with almost 70% then the initial state. Therefore, if a laparotomy should be indicated, it should be performed as soon as possible, in trying to minimize the side effects that it could have on the human body.
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