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Management of Complicated Peptic Ulcer Disease
Stephen W. Behrman, MD
Arch Surg. 2005;140:201-208.
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INTRODUCTION
If anyone should consider removing half of my good stomach to cure a small ulcer in my duodenum, I would run faster than he.
— C. E. Mayo, 1927
Our understanding of the pathophysiological features of peptic ulcer disease has rapidly evolved during the last century. Early understanding of gastric physiologic characteristics led to logical and time-tested surgical procedures aimed at acid reduction and a lowering of ulcer recurrence rates. A dramatic shift in treatment occurred with the recognition and growing knowledge of Helicobacter pylori (HP). Where once surgery dominated therapy for ulcer diathesis, medical therapy has now superseded. Just as gastric resection seemed radical to Dr Mayo, thus was medical treatment of peptic ulcer disease similarly approached with skepticism. What was the balance of medical and surgical management of peptic ulcer disease as we entered the 21st century? Complications of peptic ulcer disease requiring operative intervention . . . [Full Text of this Article]
PATHOPHYSIOLOGICAL FEATURES
Acid Secretion HP Infection Nonsteroidal Anti-Inflammatory Drugs
HP INFECTION AND UNCOMPLICATED PEPTIC ULCER DISEASE
SURGICAL COMPLICATIONS OF PEPTIC ULCER DISEASE: PATHOPHYSIOLOGICAL FEATURES AND MANAGEMENT
Perforation Bleeding Gastric Outlet Obstruction
AUTHOR INFORMATION
Author Affiliation: Department of Surgery, University of Tennessee Health Science Center–Memphis, Memphis.
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