Surgical treatment of patients with ulcerative gastroduodenal bleeding: clinical cases

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Abstract

The article presents two clinical cases of treatment of treating patients with ulcerative gastroduodenal bleeding from large chronic ulcers. In one case, the source of bleeding was a giant callous chronic gastric ulcer. The patient urgently underwent subtotal gastric resection with an inter-intestinal anastomosis according to the Roux procedure (18 hours after admission to the hospital), taking into account the high risk of recurrence of bleeding. In the second case, a patient with bleeding from a large chronic duodenal ulcer was operated on urgently (24 hours after admission to the hospital) in the following volumes: laparotomy, stitching of a duodenal ulcer, pyloroplasty according to Finney, subdiaphragmatic stem vagotomy. The purpose of the following clinical observation data is to demonstrate therapeutic tactics in relation to a group of patients with ulcerative gastroduodenal bleeding from large (more than 2.0 cm) chronic ulcers, high comorbidity and high risk of recurrence of bleeding.

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About the authors

Vladimir G. Verbitsky

Kirov Military Medical Academy; I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine

Email: verbitsky1961@mail.ru
ORCID iD: 0000-0001-6969-7270
SPIN-code: 6981-0621

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Anton O. Parfenov

Kirov Military Medical Academy; Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine

Author for correspondence.
Email: parfenov_anton@mail.ru
ORCID iD: 0009-0009-8238-678X
SPIN-code: 1620-6415

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Andrey E. Demko

Kirov Military Medical Academy; I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine

Email: demkoandrey@gmail.com
ORCID iD: 0000-0002-5606-288X
SPIN-code: 3399-8762

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Ivan P. Yastrebov

I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine

Email: ipyastreb@gmail.com
ORCID iD: 0000-0003-4139-415X
Russian Federation, Saint Petersburg

Alexey V. Kosachev

Kirov Military Medical Academy; I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine

Email: avkos1@mail.ru
ORCID iD: 0009-0005-2073-6159
SPIN-code: 6137-4356
Russian Federation, Saint Petersburg; Saint Petersburg

Egor V. Yurkevich

Kirov Military Medical Academy

Email: yurkeviche1997@mail.ru
ORCID iD: 0009-0006-2090-149X
SPIN-code: 1245-4409
Russian Federation, Saint Petersburg

References

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2. Figure. Type of surgical wound. A site of an ulcer defect on the posterior-upper wall of the duodenal bulb (intraoperative photo)

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