B17. Natural history and complications of gastro-duodenal ulcers

Page created on October 15, 2021. Last updated on March 17, 2023 at 12:31


For introduction, etiology, and pathomechanism, see the corresponding pathology 2 topic. For clinical features, diagnosis, and treatment, see topic 56 of internal medicine.

Surgical treatment of peptic ulcer disease

Surgical treatment is necessary for the treatment of complications like perforation, bleeding (if endoscopic haemostasis fails), pyloric stenosis, cases which don’t respond to conservative therapy, or if malignancy is discovered.

Perforations and bleeding ulcers may be simply sutured or closed with a patch, or they may be treated with partial gastric resection and reconstruction surgeries like Billroth I, Billroth II, or Roux-en-Y. Vagotomy may also be performed to reduce the production of stomach acid.

Many complications may occur after gastric resection:

  • Post-gastrectomy gastritis
  • Stoma stenosis
  • Dumping syndrome
  • Maldigestion
  • B12 deficiency

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