Obstructive jaundice secondary to duodenal ulcer: A case report

Authors

  • Agustín Bianco medico
  • José Gabriel Yaryura Montero
  • Agustín Ricardo Gigena
  • María Laura Petersen
  • Mario Alberto Cafaro
  • Roberto Dario
  • Rogelio Adrián Traverso

DOI:

https://doi.org/10.31053/1853.0605.v78.n2.29786

Keywords:

duodenal ulcer, jaundice, surgery, endoscopy, low back pain

Abstract

Introduction: Peptic ulcers are acid-induced lesions found in the stomach and duodenum. The prevalence of peptic ulcer disease in the United States is estimated to be 8.4%.

Objective: Describe an atypical presentation of complicated duodenal ulcer that causes jaundice and review the literature.

Case presentation: A 42-year-old male patient, who consulted for generalized jaundice and coluria, associated with low back pain treated with non-steroidal anti-inflammatory drugs. In the laboratory, total bilirubin increased to direct prevalence. A magnetic resonance cholangiography was performed that revealed duodenal thickening, with a decrease in its lumen; and a double contrast computed tomography, where thickening of the duodenal walls was observed, without oral contrast leakage. Subsequently, an upper digestive video-endoscopy was performed where a 30 mm duodenal bulb ulcer was observed. The patient presented good evolution with medical treatment, being discharged on the fifth day of hospitalization.

Discussion: Jaundice can be caused by a duodenal ulcer that causes obstruction of the common bile duct. Medical treatment may specify in selected patients. In the present case, it was established to opt for medical treatment since the patient presented hemodynamic stability, without signs of generalized peritonitis, with complementary studies in favor of a contained duodenal ulcer without free air.

Conclusion: We are dealing with a case of duodenal ulcer complicated with jaundice that presented good evolution with medical treatment.

 

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Author Biographies

Agustín Bianco, medico

Residencia de Cirugía General completa - Universidad Nacional de Córdoba. 

Médico. Universidad Nacional de Córdoba

Médico de consultorio en Sanatorio Allende

 

José Gabriel Yaryura Montero

Residencia de Cirugía General completa - Universidad Nacional de Córdoba. 

Médico. Universidad Católica de Córdoba

Médico de consultorio en Sanatorio Allende

 

Agustín Ricardo Gigena

Médico Universidad Católica de C´´órdoba 

Especialista en Ciurgía General - Universidad Nacional de Córdoba  - Sanatorio Allende

Especialista en Cirugía Endoscópica - Universidad de Chile 

Médico cirujano general y endoscoísta en Sanatorio Allende Cerro 

 

 

María Laura Petersen

Médico Universidad Nacional de Córdoba

Especialista en Ciurgía General - Universidad Nacional de Córdoba  

Residente de Cirugía Plástica - Hospital Italiano de Buenos Aires

 

Mario Alberto Cafaro

Médico Universidad Católica de Córdoba

Especialista en Ciurgía General - Universidad Nacional de Córdoba  

Residente de Cirugía Torácica - Sanatorio Allende

Roberto Dario

Médico - Universidad Nacional de Córdoba 

Especialista en Cirugía General - Universidad Nacional de Córdoba 

Fellow en Cirugía Bariátrica  y Metabólica - Universidad Católica de Córdoba

Rogelio Adrián Traverso

Médico Cirujano - Universidad Nacional de Córdoba 

Doctor en medicina y cirugía - Universidad Nacional de Córdoba 

Especialista en cirugía general - Universidad Nacional de Córdoba 

Especialista en trasplante hepático y renopancreatico

Encargado del Servicio de Cirugía General Sanatorio Allende Cerro

References

Narayanan M, Reddy KM, Marsicano E. Peptic Ulcer Disease and Helicobacter pylori infection. Mo Med. 2018 May-Jun;115(3):219-224.

Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM. Diagnosis and Treatment of Peptic Ulcer Disease. Am J Med. 2019 Apr;132(4):447-456. doi: 10.1016/j.amjmed.2018.12.009.

Kempenich JW, Sirinek KR. Acid Peptic Disease. Surg Clin North Am. 2018 Oct;98(5):933-944. doi: 10.1016/j.suc.2018.06.003.

Yilmaz S, Calikoglu EO, Kosan Z. Prevalence of obesity among adolescents in Eastern Turkey: A cross-sectional study with a review of the local literature. Niger J Clin Pract. 2019 Aug;22(8):1070-1077. doi: 10.4103/njcp.njcp_418_18.

Ho CY, Chen TS, Chang FY, Lee SD. Benign nontraumatic inflammatory stricture of mid portion of common bile duct mimicking malignant tumor: Report of two cases. World J Gastroenterol. 2004 Jul 15;10(14):2153-5. doi: 10.3748/wjg.v10.i14.2153.

Giljaca V, Gurusamy KS, Takwoingi Y, Higgie D, Poropat G, Štimac D, Davidson BR. Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones. Cochrane Database Syst Rev. 2015 Feb 26;2015(2):CD011549. doi: 10.1002/14651858.CD011549.

Hidalgo L, Repiso A, Romero M, Navajas J, Sánchez-Simón R, Gómez-Rodríguez R, Carrobles JM. Obstructive jaundice as a complication of a peptic duodenal ulcer mimicking pancreatic cancer. Endoscopy. 2010;42 Suppl 2:E294-5. doi: 10.1055/s-0030-1255785.

Gerhards MF, Vos P, van Gulik TM, Rauws EA, Bosma A, Gouma DJ. Incidence of benign lesions in patients resected for suspicious hilar obstruction. Br J Surg. 2001 Jan;88(1):48-51. doi: 10.1046/j.1365-2168.2001.01607.x.

Mekky MA, Abbas WA. Endoscopic ultrasound in gastroenterology: from diagnosis to therapeutic implications. World J Gastroenterol. 2014 Jun 28;20(24):7801-7. doi: 10.3748/wjg.v20.i24.7801.

Chiang A, Theriault M, Salim M, James PD. The incremental benefit of EUS for the identification of malignancy in indeterminate extrahepatic biliary strictures: A systematic review and meta-analysis. Endosc Ultrasound. 2019 Sep-Oct;8(5):310-317. doi: 10.4103/eus.eus_24_19.

Onstad GR, Christensen NA, Smith LA. Jaundice as a complication of duodenal ulcer. Surg Clin North Am. 1971 Aug;51(4):885-92. doi: 10.1016/s0039-6109(16)39483-x.

Published

2021-06-28

How to Cite

1.
Bianco A, Yaryura Montero JG, Gigena AR, Petersen ML, Cafaro MA, Roberto Dario, Traverso RA. Obstructive jaundice secondary to duodenal ulcer: A case report. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2021 Jun. 28 [cited 2024 Jul. 17];78(2):180-3. Available from: https://revistas.unc.edu.ar/index.php/med/article/view/29786

Issue

Section

Case Report