All of the following are indications for surgery in a case of duodenal ulcer except;
Surgery is more often required for treatment of an ulcer-related complication. Hemorrhage is the most common ulcer-related complication, Bleeding most often seen in older patients (sixth decade or beyond). Patients unresponsive or refractory to endoscopic intervention will require surgery (-5% of transfusion-requiring patients). Free peritoneal perforation occurs in -2-3% of Duodenal ulcer patients. Concomitant bleeding may occur in up to 10% of patients with perforation, with moality being increased substantially. Peptic ulcer can also penetrate into adjacent organs, especially with a posterior DU, which can penetrate into the pancreas, colon, liver, or biliary tree. Pyloric channel ulcers or DUs can lead to gastric outlet obstruction in -2-3% of patients. If a mechanical obstruction persists, endoscopic intervention with balloon dilation may be effective. Surgery should be considered if all else fails
Acute perforation of ulcer
Pyloric stenosis
Massive haemorrhage
Multiple large ulcers
Peptic Ulcer Disease