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Diagnostic Errors in Duodenal Ulcers

Year 1970, Volume: 23 Issue: 2, 406 - 415, 30.06.1970

Ferruh Uzer

Abstract

Duodenal ulcers remain a significant clinical challenge due to overlapping symptoms and radiographic ambiguities. In a five-year study (1964–1968) at Ankara University, 273 patients were surgically treated for suspected duodenal ulcers. However, in 36 cases (13.18%), intraoperative findings failed to confirm the diagnosis. The study investigates common reasons for diagnostic discrepancies, including insufficient clinical history, inadequate laboratory evaluations (such as lack of 12-hour night acid secretion test), and reliance on inconsistent radiological interpretations. The authors emphasize a multidisciplinary diagnostic approach, repeat imaging in suspicious cases, and preoperative consideration of alternative pathologies.

Keywords

Duodenal ulcer Diagnostic error Radiological misinterpretation Acid secretion test Surgical confirmation Peptic ulcer disease

References

  • 1 - BOCKUS, L. H.: Gastroenterology, W. B. Saunders Co. Vol.1: p.491, 1963.
  • 2 - BROOKS, R. J. and MOORE, D. F.: Empiricism and Rationality in Duodenal Ulcer Surgery, Surg. Clin. North Am. 46: 235, 1966.
  • 3 - COLCOCK, P. B.: The Operation of Choice for Duodenal Ulcer, Surg. Clin. North Am. 44: 653, 1964.
  • 4 - COLCOCK, P. B.: Surgical Treatment of Duodenal Ulcer, Surg. Clin. North Am. 45: 585, 1965.
  • 5 - DAVIS, L.: Christopher's Textbook of Surgery, 9th ed., W. B. Saunders Co., p. 656, 1968.
  • 6 - DRAGSTEDT, R. L.: Vagotomy in Peptic Ulcer Treatment, Surg. Clin. North Am. 46: 1153, 1966.
  • 7 - ELLISON, H. E., WILSON, D. S.: The Zollinger-Ellison Syndrome Updated, Surg. Clin. North Am. 47: 1115, 1967.
  • 8 - EWANS, H. R., ZAJTCHUK, R., MENGUY, R.: Role of Vagotomy and Drainage, Surg. Clin. North Am. 47: 141, 1967.
  • 9 - FOSTER, H. J. et al.: Surgical Management of Bleeding Ulcers, Surg. Clin. North Am. 46: 387, 1966.
  • 10 - FRY, J. W., THOMPSON, W. N.: Vagotomy and Pyloroplasty, Surg. Clin. North Am. 46: 359, 1966.
  • 11 - GRIFFITH, A. C.: Selective Gastric Vagotomy, Surg. Clin. North Am. 46: 367, 1966.
  • 12 - MAINGOT, R.: Abdominal Operations, 5th ed., Appleton-Century-Crofts, Vol. I., p. 179, 1969.
  • 13 - MESCHAN, I.: Roentgen Signs in Clinical Practice, Vol. II., W. B. Saunders Co., p. 1513, 1966.
  • 14 - PRIESTLEY, T. J.: Chronic Duodenal Ulcer, Surg. Clin. North Am. 47: 841, 1967.
  • 15 - SAWYERS, L. J. et al.: Truncal vs. Selective Gastric Vagotomy, Am. J. Surg. Feb., p. 165, 1968.
  • 16 - SCHATZKI, R. et al.: Radiological Diagnosis in Acute Abdominal Disease, Surg. Clin. North Am. 46: 513, 1966.
  • 17 - SCOTT, W. H.: Vagotomy and Antrectomy in Duodenal Ulcer Treatment, Surg. Clin. North Am. 46: 349, 1966.
  • 18 - SEDGWICK, E. C., VERNON, K. J.: GI Bleeding Diagnosis and Management, Surg. Clin. North Am. 48: 523, 1968.
  • 19 - SEDGWICK, E. C.: Unusual Lesions of the Duodenum, Surg. Clin. North Am. 44: 665, 1964.
  • 20 - SHEDD, P. D., GOLDENBERG, S. I.: Management of Perforated Peptic Ulcer, Surg. Clin. North Am. 46: 379, 1966.
  • 21 - SYNDER, N. E.: Emergency Surgery in Bleeding Ulcer, Am. J. Surg. Aug., p. 170, 1968.
  • 22 - TITIZ, I. ve Ark.: İç Hastalıkları, Türk Tarih Kurumu Basımevi, s. 230, 1962.
  • 23 - WELCH, E. C.: Subtotal Gastrectomy for Duodenal Ulcer, Surg. Clin. North Am. 46: 339, 1966.

Duodenum Ülserlerinin Tanısında Yanılma Nedenleri

Year 1970, Volume: 23 Issue: 2, 406 - 415, 30.06.1970

Ferruh Uzer

Abstract

Duodenum ülserleri, klinik belirtiler ve radyolojik bulguların örtüşmesi nedeniyle tanısal olarak güçlük oluşturmaktadır. Ankara Üniversitesi I. Cerrahi Kliniği’nde 1964–1968 yılları arasında duodenum ülseri tanısı ile ameliyat edilen 273 vakadan 36’sında (%13,18) tanı ameliyatta doğrulanamamıştır. Bu çalışmada tanıdaki yanılma sebepleri olarak, yetersiz anamnez, 12 saatlik gece sekresyon testinin uygulanmaması, radyolojik yorum farklılıkları ve önceki cerrahi girişimlerin etkisi araştırılmıştır. Yazarlar, kesin tanıya ulaşmak için klinik, laboratuvar ve radyolojik bulguların birlikte değerlendirilmesi gerektiğini vurgulamakta; şüpheli vakalarda görüntülemelerin tekrarlanmasını ve alternatif patolojilerin dikkate alınmasını önermektedir.

References

  • 1 - BOCKUS, L. H.: Gastroenterology, W. B. Saunders Co. Vol.1: p.491, 1963.
  • 2 - BROOKS, R. J. and MOORE, D. F.: Empiricism and Rationality in Duodenal Ulcer Surgery, Surg. Clin. North Am. 46: 235, 1966.
  • 3 - COLCOCK, P. B.: The Operation of Choice for Duodenal Ulcer, Surg. Clin. North Am. 44: 653, 1964.
  • 4 - COLCOCK, P. B.: Surgical Treatment of Duodenal Ulcer, Surg. Clin. North Am. 45: 585, 1965.
  • 5 - DAVIS, L.: Christopher's Textbook of Surgery, 9th ed., W. B. Saunders Co., p. 656, 1968.
  • 6 - DRAGSTEDT, R. L.: Vagotomy in Peptic Ulcer Treatment, Surg. Clin. North Am. 46: 1153, 1966.
  • 7 - ELLISON, H. E., WILSON, D. S.: The Zollinger-Ellison Syndrome Updated, Surg. Clin. North Am. 47: 1115, 1967.
  • 8 - EWANS, H. R., ZAJTCHUK, R., MENGUY, R.: Role of Vagotomy and Drainage, Surg. Clin. North Am. 47: 141, 1967.
  • 9 - FOSTER, H. J. et al.: Surgical Management of Bleeding Ulcers, Surg. Clin. North Am. 46: 387, 1966.
  • 10 - FRY, J. W., THOMPSON, W. N.: Vagotomy and Pyloroplasty, Surg. Clin. North Am. 46: 359, 1966.
  • 11 - GRIFFITH, A. C.: Selective Gastric Vagotomy, Surg. Clin. North Am. 46: 367, 1966.
  • 12 - MAINGOT, R.: Abdominal Operations, 5th ed., Appleton-Century-Crofts, Vol. I., p. 179, 1969.
  • 13 - MESCHAN, I.: Roentgen Signs in Clinical Practice, Vol. II., W. B. Saunders Co., p. 1513, 1966.
  • 14 - PRIESTLEY, T. J.: Chronic Duodenal Ulcer, Surg. Clin. North Am. 47: 841, 1967.
  • 15 - SAWYERS, L. J. et al.: Truncal vs. Selective Gastric Vagotomy, Am. J. Surg. Feb., p. 165, 1968.
  • 16 - SCHATZKI, R. et al.: Radiological Diagnosis in Acute Abdominal Disease, Surg. Clin. North Am. 46: 513, 1966.
  • 17 - SCOTT, W. H.: Vagotomy and Antrectomy in Duodenal Ulcer Treatment, Surg. Clin. North Am. 46: 349, 1966.
  • 18 - SEDGWICK, E. C., VERNON, K. J.: GI Bleeding Diagnosis and Management, Surg. Clin. North Am. 48: 523, 1968.
  • 19 - SEDGWICK, E. C.: Unusual Lesions of the Duodenum, Surg. Clin. North Am. 44: 665, 1964.
  • 20 - SHEDD, P. D., GOLDENBERG, S. I.: Management of Perforated Peptic Ulcer, Surg. Clin. North Am. 46: 379, 1966.
  • 21 - SYNDER, N. E.: Emergency Surgery in Bleeding Ulcer, Am. J. Surg. Aug., p. 170, 1968.
  • 22 - TITIZ, I. ve Ark.: İç Hastalıkları, Türk Tarih Kurumu Basımevi, s. 230, 1962.
  • 23 - WELCH, E. C.: Subtotal Gastrectomy for Duodenal Ulcer, Surg. Clin. North Am. 46: 339, 1966.
There are 23 citations in total.

Details

Primary Language English
Subjects General Surgery
Journal Section Articles
Authors

Ferruh Uzer This is me

Publication Date June 30, 1970
Published in Issue Year 1970 Volume: 23 Issue: 2

Cite

APA Uzer, F. (1970). Diagnostic Errors in Duodenal Ulcers. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 23(2), 406-415.
AMA Uzer F. Diagnostic Errors in Duodenal Ulcers. Ankara Üniversitesi Tıp Fakültesi Mecmuası. June 1970;23(2):406-415.
Chicago Uzer, Ferruh. “Diagnostic Errors in Duodenal Ulcers”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 23, no. 2 (June 1970): 406-15.
EndNote Uzer F (June 1, 1970) Diagnostic Errors in Duodenal Ulcers. Ankara Üniversitesi Tıp Fakültesi Mecmuası 23 2 406–415.
IEEE F. Uzer, “Diagnostic Errors in Duodenal Ulcers”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 23, no. 2, pp. 406–415, 1970.
ISNAD Uzer, Ferruh. “Diagnostic Errors in Duodenal Ulcers”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 23/2 (June1970), 406-415.
JAMA Uzer F. Diagnostic Errors in Duodenal Ulcers. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1970;23:406–415.
MLA Uzer, Ferruh. “Diagnostic Errors in Duodenal Ulcers”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 23, no. 2, 1970, pp. 406-15.
Vancouver Uzer F. Diagnostic Errors in Duodenal Ulcers. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1970;23(2):406-15.