Maagperforatie bij Oost-Europese arbeidsmigranten

Klinische les
23-04-2019
Maarten A. Beek, Alexander G.L. Bodelier en Rogier M.P.H. Crolla

Dames en Heren,

Ulcera in de maag komen in Nederland steeds minder voor. De kans dat u bij een patiƫnt geconfronteerd wordt met een complicatie van ulcuslijden als eerste uiting van deze aandoening is daardoor klein geworden. Een uitzondering hierop vormen arbeidsmigranten uit Oost-Europa, waar de prevalentie van Helicobacter pylori hoger is. Bij Oost-Europese migranten met acuut ontstane, hevige pijn in epigastrio moet u bedacht zijn op een maagperforatie.

Gastric perforation in Eastern European economic migrants

The general prevalence of perforated peptic ulcers is decreasing and they are, therefore, more likely to be missed. In our hospital, Eastern European migrants are overrepresented in the population of patients with perforated gastric peptic ulcers; due to a higher prevalence of Helicobacter pylori in Eastern Europe, they have a higher chance of developing gastric peptic ulcers than patients of Dutch origin. Treatment is hampered by the language barrier and low compliance rates, with patients often leaving hospital against medical advice and not showing up for follow-up appointments. These patients should, therefore, be informed by an interpreter, so that they are well educated about the disease and its treatment. Furthermore, we advise determination of the presence of H. pylori in these patients either during or directly after surgery, and, if necessary, empirical eradication of the bacteria.

Conflict of interest and financial support: none declared.