Nonoperative Treatment of Perforated Duodenal Ulcer: A Case Report and Review of the Literature

穿孔性十二指腸潰瘍的非手術治療：病例報告

張瀚文(Han-Wen Chang) ； 蔡維謀(Wai-Mau Choi)

《中華民國急救加護醫學會雜誌》 18卷4期 (2007/12) Pp. 167-172

https://doi.org/10.30018/JECCM.200712.0005

摘要

我們遇到一例穿孔性十二指腸潰瘍。起初是籍由內視鏡發現十二指腸潰瘍，站立胸部X光及腹部電腦斷層確認是十二指腸潰瘍穿孔並排除其他腹腔內病灶。因為水溶性胃十二指腸攝影術顯示十二指腸潰瘍穿孔已癒合而且病人情況穩定，我們決定採取非手術治療並密切觀察臨床變化。病人經由非手術治療後臨床上有改善。我們相信水溶性胃十二指腸攝影術可以用來判斷穿孔是否癒合，已癒合的穿孔性十二指腸潰瘍允許非手術治療，並可以籍此減低這類病人手術的機會。

關鍵字

非手術治療 ； 穿孔性十二指腸潰瘍 ； 水溶性胃十二指腸攝影術

並列摘要

We present a case of perforated duodenal ulcer which was first considered using the results of the endoscopy examination. Erect chest radiography and abdominal CT scan identified the site of the perforation and excluded other intra-abdominal lesions. Sealed perforated duodenal ulcer was shown on water soluble gastroduodenogram. As the patient's general condition remained stable, we prescribed nonoperative management and patient's clinical condition was closely monitored. The patient had clinical improvement after undergoing nonoperative treatments. It is believed that water soluble gastroduodenogram may help the diagnosis of sealed perforation. Sealed perforated duodenal ulcer allows for nonoperative management and may reduce the need for surgery in such patients.

並列關鍵字

nonoperative treatment ； perforated duodenal ulcer ； water soluble gastroduodenogram