CLINICAL TACTICS IN CASE OF MULTIPLE COMPLICATIONS OF PEPTIC ULCER DISEASE: A CASE FROM PRACTICE

Peptic ulcer disease is a major health problem due to its potential complications such as bleeding, perforation, penetration, stenosis, malignancy. The most common of these is bleeding, followed by perforation, which is the main indication for emergency surgery and causes most deaths. Penetration into adjacent organs manifests itself with atypical symptoms, which complicates diagnosis. The results of the examination may be distorted, since signs of peritonitis may be minimal. Surgical outcomes in patients with such complications as bleeding, perforation, penetration, stenosis in combinations is rare in literature. Timely diagnosis and treatment require high-quality anamnesis and examination of the patient. Surgical treatment of multiple complications of ulcer in one patient is a complex clinical problem associated with the choice of the method of intervention, the need for an interdisciplinary approach, high risk of decompensation. Based on the presented clinical observation, the authors draw attention to the issues of clinical manifestations, diagnosis, and treatment of a patient with gastric ulcer complicated by bleeding, stenosis, and ulcer penetration into the hepatoduodenal ligament and head of the pancreas. Emphasizing the diagnostic di–culties associated with a combination of such a number of gastric ulcer complications at the same time, the presentation of this clinical case is aimed at improving the quality of diagnosis and tactics of surgical treatment.