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Peptic Ulcer Disease
Peptic Ulcer Complications
Bariatrics
Complications of Bariatric Surgery
Pearls
100
The percentage of patients with a duodenal ulcer found to be infected with H. pylori.
What is 95%
100
Of the two scoring systems for upper gastrointestinal bleeding, Rockall and Blatchford, this one is the most detailed and likely to be the most useful.
What is Rockall
100
The number of years lost in terms of life expectancy for obese smokers, according to the results of an analysis of the Framingham Heart Study.
What is 14
100
Authors from an article published in Surgery, 2009, noted a 1% incidence of PE S/P gastric bypass. Choosing from the values of 0.77%, 0.54% or 0.36% the authors were able to reduce the rate of PE to this value using a protocol driven approach
What is 0.36%
100
Has been erroneously attributed to be the etiology of fever in the first 24-48 hours postoperatively
What is atelectasis
200
Christensen and coauthors in Chest, 2008, identified this lung disease as a significant risk factor that influences outcomes from peptic ulcer complications.
What is COPD
200
For bleeding gastric ulcers that are successfully treated with endoscopic therapy, follow-up endoscopy is necessary and cost effective to exclude this disease
What is gastric cancer
200
At 10 year follow-up, according to the authors of an article published in the NEJM in 2007, weight loss for surgically treated patients had stabilized at this percentage
What is 25%
200
Has been suggested as an important diagnostic as well as therapeutic intervention in patients who have recently undergone a gastric bypass procedure and are suspected of having an anastamotic leak.
What is re-exploration
200
A clear plastic tube that has been clearly shown to be of no benefit for the vast majority of patients who undergo gastric, small bowel or colon resections.
What is a nasogastric tube
300
A lower risk of upper gastrointestinal complications was associated with COX2 inhibitors, however, the relative reduction in risk for use of COX2 inhibitors was shown to be eliminated by concomitant use of this medication.
What is aspirin
300
Suture closure of a duodenal perforation as a result of a duodenal ulcer with or without this maneuver is effective therapy.
What is omental patching
300
The minimum BMI set forth by the NIH as a clear indication for bariatric surgery for patients with NO co-morbid conditions.
What is 40
300
According to a published review of 347 patients who underwent gastric band placement, this was the reported incidence of band erosion.
What is 6.8%
300
A surgical approach that is NOT contraindicated in patients who have undergone one or several open abdominal operations.
What is the laparoscopic approach
400
Obesity, smoking and aspirin use with regards to the development of gastric ulcers.
What are risk factors
400
Authors of a meta-analysis of randomized controlled trials concluded that patients who are successfully fed enterally may not require the use of this drug to decrease the incidence of stress gastrointestinal bleeding and that in fact the use of this drug may INCREASE the risk of pneumonia in the enterally fed patients.
What are H2 blockers
400
The reported rate of morbidity and mortality of patients undergoing Roux-en-Y gastric bypass or lap band at centers specializing in bariatric surgery.
What is 4.3% and 0.3%
400
Is an ulcer of uncertain etiology that when it develops usually occurs at the gastrojejunal anastomosis in patients who have undergone a gastric bypass operation.
What is a marginal ulcer
400
The best surgical subspecialty
What is pediatric surgery
500
Available data reviewed by Napolitano in Gastroenterology Clinics of North America in 2009, suggests improved ulcer healing and lower rates of ulcer recurrence when triple therapy consisting of these medications is used in H. pylori positive patients.
What is a PPI, clarithromycin and either amoxicillin or metronidazole
500
This condition is the result of migration of a gallstone through a cholecystenteric fistula into the duodenum with obstruction of the pylorus.
What is Bouveret syndrome
500
Contemporary practice suggests that a gastric pouch of this volume be created with a staple line that excludes the gastric fundus.
What is 30-40ml
500
S/P gastric bypass it is a surgical emergency that frequently presents with symptoms consistent with bowel obstruction, elevated amylase and diffuse abdominal pain.
What is an internal hernia (incarcerated/strangulated)
500
The pioneer of the gastric bypass operation
Who is Edward Mason, MD, PhD