Report of a case involving novel use of a post-operative esophagogastroduodenoscopy to re-evaluate a duodenal ulcer bleed.

Title

Report of a case involving novel use of a post-operative esophagogastroduodenoscopy to re-evaluate a duodenal ulcer bleed.

Creator

DeVito R;Shoukry S;Arif A;Fullmer R;Simpson M;Kimyaghalam A

Publisher

International Journal of Surgery Case Reports

Date

2020
2020-10-23

Description

INTRODUCTION: Acute gastrointestinal (GI) bleeding can be a life-threatening condition. This is usually diagnosed and managed by an upper GI tract endoscopy. When treating actively bleeding duodenal ulcers, surgical intervention, or arterial embolization by Interventional Radiology (IR) is warranted in the event of failed initial management. We present a patient with a significant GI bleed and failure of management through endoscopy, necessitating emergent surgical intervention. PRESENTATION OF CASE: An 87-year-old female presented to the emergency department after a fall. Her hemoglobin level dropped significantly and an esophagogastroduodenoscopy (EGD) revealed a large pool of blood in the stomach but had a limited view of an active bleed. The patient was taken emergently to the operating room (OR) where she underwent an exploratory laparotomy, gastroduodenostomy, suture ligation, and pyloroplasty. The following day, she had increased sanguineous output from her nasogastric (NG) tube. Re-evaluation was done with an EGD in the OR. The patient tolerated all procedures well and was transferred to a facility with IR capabilities for further management. DISCUSSION: An EGD hours after gastroduodenostomy runs a high risk for perforation and is not the typical course of action. Given the lack of IR availability and concern for rebleeding, this procedure was performed in the OR to minimize risk. CONCLUSION: A favorable outcome was achieved with this patient and hemostasis was confirmed with the post-operative EGD. Further studies will determine whether this approach is a viable option for facilities without IR until the patient can be transferred.

Subject

Surgery; Endoscopy; Case report; Bleeding; Duodenum; Repair; Ulcer

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

15-17

Volume

77

ISSN

2210-2612 2210-2612 2210-2612

NEOMED College

NEOMED College of Medicine Student

NEOMED Department

NEOMED Student Publications

Update Year & Number

October 2020 List

Citation

DeVito R;Shoukry S;Arif A;Fullmer R;Simpson M;Kimyaghalam A, “Report of a case involving novel use of a post-operative esophagogastroduodenoscopy to re-evaluate a duodenal ulcer bleed.,” NEOMED Bibliography Database, accessed January 17, 2021, https://neomed.omeka.net/items/show/11334.

Social Bookmarking