Outcomes of cocaine-induced gastric perforations repaired with an omental patch

Schuster, Kevin M.; Feuer, William J.; Barquist, Erik S.
November 2007
Journal of Gastrointestinal Surgery;Nov2007, Vol. 11 Issue 11, p1560
Academic Journal
journal article
Crack cocaine has been associated with acute gastric perforation. The appropriate surgical treatment and long-term outcomes remain unclear. A retrospective chart review of all gastroduodenal perforations associated with crack cocaine use was performed. Data abstracted included details of short- and long-term outcomes. Kaplan-Meier methods were used to evaluate surgical outcomes. Over the 14-year period ending December 2005, 16 cases of crack-induced gastric perforations were identified. Most (75%) were treated with an omental patch. The other patients underwent a formal antiulcer operation, including one vagotomy and pyloroplasty (V&P), one vagotomy and antrectomy, one subtotal gastrectomy, and one ulcer excision and V&P. All patients after antiulcer procedures were followed for a median of 63 months (range 27-120) with no recurrences. Follow-up data were available in 75% of the omental patch patients. Recurrence of disease was observed in 56% of these omental patch patients at a median of 20 months (range 11-39). Those without recurrence were followed for a median of 67 months (range 12-96). The recurrence rate was borderline lower in the antiulcer group (P = 0.072). Omental patch closure results in a recurrence rate over 50% compared with no recurrence for formal antiulcer procedures.


Related Articles

  • Esophageal cancer after distal gastrectomy. Hashimoto, N.; Inayama, M.; Fujishima, M.; Ho, H.; Shinkai, M.; Hirai, N.; Kawanishi, K.; Imano, M.; Shigeoka, H.; Imamoto, H.; Shiozaki, H. // Diseases of the Esophagus;Oct2006, Vol. 19 Issue 5, p346 

    The effect of gastrectomy on the subsequent development of esophageal cancer was investigated. Duodenogastroesophageal reflux is thought to be common in patients after distal gastrectomy, but whether this contributes to the development of esophageal cancer in such patients is controversial. We...

  • The Operation of Choice for Peptic Ulcer Disease. Rosemond, George P.; Reichle, Frederick a. // American Journal of Gastroenterology;Nov1967, Vol. 48 Issue 5, p392 

    Focuses on surgical procedure for peptic ulcer disease. Potential hazards of subtotal gastrectomy; Information on hemigastrectomy and vagotomy; Discussion on distal gastroenterostomy and vagotomy.

  • Ulcer Recurrence After Gastric Surgery: Is Helicobacter pylori the Culprit? Lee, Y. T.; Sung, Joseph J. Y.; Choi, C. L.; Chan, Francis K. L.; Ng, Enders K. W.; Ching, Y. L.; Leung, W. K.; Chung, S. C. Sydney // American Journal of Gastroenterology;Jun1998, Vol. 93 Issue 6, p928 

    Objectives: Helicobacter pylori is the most important cause of recurrent peptic ulcer disease. However, its role in ulcer recurrence after peptic ulcer surgery is unclear. We aimed at studying the prevalence and distribution of H. pylori in patients who had undergone peptic...

  • THE CHOICE OF OPERATION FOR DUODENAL ULCER. Amendola, Frederick H. // American Journal of Gastroenterology;Aug1965, Vol. 44 Issue 2, p118 

    Evaluates the common surgical operations performed for duodenal ulcer. Mortality rate of vagotomy with a drainage procedure; Complication of standard subtotal gastrectomy; Efficacy of limited gastrectomy with vagotomy procedure; Importance of understanding the physiology of gastric secretion to...

  • A Rare Case of Acute Perforation of Gastrojejunal Ulcer. Chittora, Anurag // Internet Journal of Surgery;2009, Vol. 19 Issue 2, p4 

    Stomal ulcers occur after gastroenterostomy or gastrectomy of the Billroth II type. The jejunal loop is exposed directly to the gastric acid, so the ulcer is usually found on the jejunal side of the stoma. Gastric staple line disruption, marginal ulcer, hemorrhage and stomal stenosis are well...

  • Managing Recurrent Peptic Ulcer Bleeding: The Scalpel or the Scope? Arai, Ronen; Barkin, Jamie S.; Johnson, David // American Journal of Gastroenterology;Nov1999, Vol. 94 Issue 11, p3365 

    This prospective randomized study compared endoscopic retreatment with surgery for patients whose peptic ulcers rebled after initial endoscopic hemostasis had been achieved. Over a 3 1/2-yr period at a single institution in Hong Kong, 3473 adult patients were admitted with the diagnosis of...

  • Cross-national changes in the effects of peptic ulcer disease. Bloom, Bernard S.; Bloom, B S // Annals of Internal Medicine;4/1/91, Vol. 114 Issue 7, p558 

    Objective: To describe and to analyze the changing effects of peptic ulcer disease over time.Design: Variables relating to peptic ulcer disease from 1970-1986 were compared. The variables included rates of mortality, hospitalizations, operations, physician visits, and...

  • Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers. Tait, Laura F.; Ortega, Gezzer; Tran, Daniel D.; Fullum, Terrence M. // Case Reports in Surgery;2012, p1 

    Background. Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for type 2 diabetes mellitus (T2DM) in patients with morbid obesity. However, it is unclear just how effective the LRYGB procedure is on T2DM for patients with BMI less than 35 kg/m². We...

  • A Life-saving but Inadequately Discussed Procedure: Tube Duodenostomy. Known and Unknown Aspects. Isik, Burak; Yilmaz, Sezai; Kirimlioglu, Vedat; Sogutlu, Gokhan; Yilmaz, Mehmet; Katz, Daniel // World Journal of Surgery;Aug2007, Vol. 31 Issue 8, p1616 

    The most successful method of managing the difficult duodenum, including the stump leakage, has been the tube duodenostomy technique, but it has not gained wide acceptance and is rarely used. The purpose of this study is to describe the details of the procedure for indication, technical...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics