TY  - JOUR
T1  - 'kissing' duodenal ulcers
AU  - Stabile BE, Hardy HJ, Passaro E, Jr
Y1  - 1979/10/01
N1  - 10.1001/archsurg.1979.01370340059010
JO  - Archives of Surgery
SP  - 1153
EP  - 1156
VL  - 114
IS  - 10
N2  - • Among 70 cases of perforated duodenal ulcers treated by plication, eight were complicated by massive postoperative hemorrhage from a syncronous posterior "kissing" duodenal ulcer. Critical analysis revealed that only signs of gastrointestinal (GI) bleeding preoperatively had predictive value for postoperative hemorrhage. Twenty-four patients had one or more predictive signs, and eight actually bled postoperatively. There was a 50% mortality and 75% additional complication rate for the bleeders. In contrast, the nonbleeders had a mortality and a complication rate of only 18% and 35%, respectively. There was no observed superiority of either surgical or medical treatment for postoperative hemorrhage. In perforated duodenal ulcer with evidence of Gl blood loss, an intraoperative search for a posterior kissing ulcer is recommended. If a kissing ulcer is found, an acid-reducing operation and suture ligation of the ulcer is indicated.(Arch Surg 114:1153-1156, 1979)
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.1979.01370340059010
UR  - http://dx.doi.org/10.1001/archsurg.1979.01370340059010
ER  -