Helicobacter pylori除菌後に十二指腸潰瘍穿孔を来した1例

抄録

A 56-year-old man was admitted because of an upper abdominal pain. He had taken successfully the eradication of Helicobacter pylori in duodenal ulcer 10 years ago. He had smoked 20 cigarettes a day for about 30 years. He didn’t take NSAIDs. On February 2017 he had suddenly severe epigastric pain and he visited our hospital by an ambulance. With rebound tenderness, Abdominal Computed Tomography revealed opacity of the adipose tissue around the duodenum as well as free air at around gallbladder bed. He was diagnosed duodenal ulcer perforation and had emergency operation. 5 mm perforation was found at an anterior of duodenal bulb in laparotomy findings. The perforated site was filled and covered with omentum, and the abdominal cavity was drainage after irrigation. He had a favorable postoperative course treated with omeprazole and discharged on postoperatively day 15. After having taken omeprazole for 12 weeks, he has taken medication of Lafutidine as maintenance therapy. He didn’t have Helicobacter pylori infection by urea breath test. He has been under follow-up as an outpatient and well with no abdominal complaints.