Operative Control of Bleeding Ulcer at Posterior Wall of Duodenal Bulb: How I Do It

Authors

  • Darin Lohsiriwat Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Varut Lohsiriwat Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

Abstract

The most important cause of major life threatening acute upper gastro intestinal bleeding is peptic ulcer. Bleeding from a large posterior duodenal ulcer which erodes the gastroduodenal artery can be particularly severe. In bleeding peptic ulcers, definitive hemostasis can be achieved by endoscopic treatment in more than 90% of cases. Immediate emergency surgery may be necessary for bleeding refractory or inaccessible to endoscopic control. The authors reviewed surgical anatomy of gastroduodenal artery complex and demonstrated operative technique to control bleeding from an ulcer at posterior wall of duodenal bulb.

References

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Published

2004-12-30

How to Cite

1.
Lohsiriwat D, Lohsiriwat V. Operative Control of Bleeding Ulcer at Posterior Wall of Duodenal Bulb: How I Do It. Thai J Surg [Internet]. 2004 Dec. 30 [cited 2024 Apr. 27];25(4):113-5. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/242285

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Original Articles