A CASE OF SEVERLY STENOTIC POSTBULBAR DUODENAL ULCER PRESENTED WITH ACUTE RENAL FAILURE

Abstract

A 34-year-old man was brought into the hospital by ambulance because of a 3-day history of frequent vomiting, general fatigue and dyspnea. He had been treated for duodenal ulcer at another hospital 6 years before admission. On admission, the patient showed a sign of acute pre-renal failure due to dehydration with high BUN and serum creatinine levels of 68.5mg/dl and 6.8mg/dl, respectively.
Arterial blood gas analysis showed the presence of metabolic alkalosis, which was attributed to the loss of gastric juice by frequent vomiting. Continuous hemo-filtration was instituted with effects for his acute renal failure with oliguria. Gastrointestinal endoscopy confirmed the presence of post-bulbar duodenal ulcer causing sever stenosis. No evidence of malignancy was noted. Distal gastrectomy with Billroth II method was performed on 34^th hospital day with a smooth postoperative recovery.