CC BY-NC-ND 4.0 · AJP Rep 2025; 15(01): e32-e35
DOI: 10.1055/a-2533-2017
Case Report

Duodenal Peptic Ulcer Perforation in the Puerperium Case Report Series

1   Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York
,
Andre Robinson
1   Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York
,
Erin Fitzgerald
2   Department of Surgery, NYU Langone Health, New York, New York
,
Marie Fleury
2   Department of Surgery, NYU Langone Health, New York, New York
,
Andrew Rubenstein
1   Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York
› Institutsangaben

Abstract

Peptic ulcers and complications, such as perforation, are rare during pregnancy and the puerperium. Accordingly, many clinicians may place these diagnoses low on their differential diagnosis. We present two case reports of primigravida, advanced maternal-age females with a history of irritable bowel syndrome and nonsteroidal anti-inflammatory drug use found to have perforated duodenal ulcers after cesarean section. Postpartum surgical abdomens may not present with classic guarding and rigidity. A low threshold for imaging and identification of risk factors is critical to timely diagnosis and management.



Publikationsverlauf

Eingereicht: 05. November 2024

Angenommen: 27. November 2024

Accepted Manuscript online:
05. Februar 2025

Artikel online veröffentlicht:
04. März 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Johnston JL. Peptic ulcer and pregnancy; deaths from perforation and hemorrhage of peptic ulcer during pregnancy. Obstet Gynecol 1953; 2 (03) 290-296
  • 2 Cappell MS. Gastric and duodenal ulcers during pregnancy. Gastroenterol Clin North Am 2003; 32 (01) 263-308
  • 3 Munro A, Jones PF. Abdominal surgical emergencies in the puerperium. BMJ 1975; 4 (5998) 691-694
  • 4 Engemise S, Oshowo A, Kyei-Mensah A. Perforated duodenal ulcer in the puerperium. Arch Gynecol Obstet 2009; 279 (03) 407-410
  • 5 Jain A, Azzolini A, Kipnis S. A unique presentation of perforated duodenal ulcer in a postpartum woman: a case report. J Surg Case Rep 2020; 2020 (12) rjaa459
  • 6 Tan EK. Postpartum abdominal pain–have you excluded a perforated ulcer?. J Obstet Gynaecol 2004; 24 (05) 582-584
  • 7 Miles Dua S, Morrison C, Farrant J, Rolles K. Postpartum pneumoperitoneum: an important clinical lesson. BMJ Case Rep 2012; 2012: bcr0620103103
  • 8 Maruyama S, Sato Y, Nakaki A, Satake Y, Emoto I, Kim T. Postpartum duodenal perforation after acute fatty liver of pregnancy. J Obstet Gynaecol 2016; 36 (01) 58-59
  • 9 Shirazi M, Zaban MT, Gummadi S, Ghaemi M. Peptic ulcer perforation after cesarean section; case series and literature review. BMC Surg 2020; 20 (01) 110
  • 10 Bartolo AD, Sircar S, Mitchell R. Post-partum duodenal perforation. N Z Med J 2020; 133 (1516) 97-99
  • 11 Bollag L, Lim G, Sultan P. et al. Society for obstetric anesthesia and perinatology: consensus statement and recommendations for enhanced recovery after cesarean. Anesth Analg 2021; 132 (05) 1362-1377
  • 12 Tran-Duy A, Vanmolkot FH, Joore MA, Hoes AW, Stehouwer CD. Should patients prescribed long-term low-dose aspirin receive proton pump inhibitors? A systematic review and meta-analysis. Int J Clin Pract 2015; 69 (10) 1088-1111
  • 13 Jardim KHC, Silva JT, Franco IGdP, Mitre GS, Nakaoka VYEdS, Lima RA. Duodenal ulcer perforation in the puerperium: a case report. J Med Case Rep 2022; 5 (05) nov03110483
  • 14 Sule EA, Omo-Aghoja L. Perforated duodenal ulcer in the immediate puerperium following caesarean section. J Obstet Gynaecol 2010; 30 (06) 633-635