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冯 敏, 陈 哲, 程 永. [A case of duodenal ulcer as prominent manifestation of IgG4-related disease]. Beijing Da Xue Xue Bao Yi Xue Ban 2023; 55:1125-1129. [PMID: 38101799 PMCID: PMC10724000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Indexed: 12/17/2023]
Abstract
A case of IgG4-related disease presented with a duodenal ulcer to improve the understan-ding of IgG4-related diseases was reported. A 70-year-old male presented with cutaneous pruritus and abdominal pain for four years and blackened stools for two months. Four years ago, the patient went to hospital for cutaneous pruritus and abdominal pain. Serum IgG4 was 3.09 g/L (reference value 0-1.35 g/L), alanine aminotransferase 554 U/L (reference value 9-40 U/L), aspartate aminotransferase 288 U/L (reference value 5-40 U/L), total bilirubin 54.16 μmol/L (reference value 2-21 μmol/L), and direct bilirubin 29.64 μmol/L (reference value 1.7-8.1 μmol/L) were all elevated. The abdominal CT scan and magnetic resonance cholangiopancreatography indicated pancreatic swelling, common bile duct stenosis, and secondary obstructive dilation of the biliary system. The patient was diagnosed with IgG4-related disease and treated with prednisone at 40 mg daily. As jaundice and abdominal pain improved, prednisone was gradually reduced to medication discontinuation. Two months ago, the patient developed melena, whose blood routine test showed severe anemia, and gastrointestinal bleeding was diagnosed. The patient came to the emergency department of Beijing Hospital with no improvement after treatment in other hospitals. Gastroscopy revealed a 1.5 cm firm duodenal bulb ulcer. After treatment with omeprazole, the fecal occult blood was still positive. The PET-CT examination was performed, and it revealed no abnormality in the metabolic activity of the duodenal wall, and no neoplastic lesions were found. IgG4-related disease was considered, and the patient was admitted to the Department of Rheumatology and Immunology of Beijing Hospital for further diagnosis and treatment. The patient had a right submandibular gland mass resection history and diabetes mellitus. After the patient was admitted to the hospital, the blood test was reevaluated. The serum IgG4 was elevated at 5.44 g/L (reference value 0.03-2.01 g/L). Enhanced CT of the abdomen showed that the pancreas was mild swelling and was abnormally strengthened, with intrahepatic and extrahepatic bile duct dilation and soft tissue around the superior mesenteric vessels. We pathologically reevaluated and stained biopsy specimens of duodenal bulbs for IgG and IgG4. Immunohistochemical staining revealed remarkable infiltration of IgG4-positive plasma cells into duodenal tissue, the number of IgG4-positive cells was 20-30 cells per high-powered field, and the ratio of IgG4/IgG-positive plasma cells was more than 40%. The patient was treated with intravenous methylprednisolone at 40 mg daily dosage and cyclophosphamide, and then the duodenal ulcer was healed. IgG4 related disease is an immune-medicated rare disease characterized by chronic inflammation and fibrosis. It is a systemic disease that affects nearly every anatomic site of the body, usually involving multiple organs and diverse clinical manifestations. The digestive system manifestations of IgG4-related disease are mostly acute pancreatitis and cholangitis and rarely manifest as gastrointestinal ulcers. This case confirms that IgG4-related disease can present as a duodenal ulcer and is one of the rare causes of duodenal ulcers.
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Affiliation(s)
- 敏 冯
- />北京医院风湿免疫科, 国家老年医学中心, 中国医学科学院老年医学研究院, 北京 100730Department of Rheumatology, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 哲 陈
- />北京医院风湿免疫科, 国家老年医学中心, 中国医学科学院老年医学研究院, 北京 100730Department of Rheumatology, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 永静 程
- />北京医院风湿免疫科, 国家老年医学中心, 中国医学科学院老年医学研究院, 北京 100730Department of Rheumatology, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
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Iijima K. [How to use acid secretion inhibitors considering the etiology of gastric and duodenal ulcers]. Nihon Shokakibyo Gakkai Zasshi 2023; 120:827-836. [PMID: 37821372 DOI: 10.11405/nisshoshi.120.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Affiliation(s)
- Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine
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Abstract
Eosinophilic gastroenteritis (EGE)-associated duodenal ulcer is rare and its endoscopic and pathological features remain poorly described. A 15-year-old boy was referred to our hospital for further examination and treatment of duodenal ulcer. Esophagogastroduodenoscopy (EGD) revealed two A2-stage duodenal ulcers on the duodenal bulb. A biopsy revealed marked infiltration of eosinophils, suggestive of EGE-associated duodenal ulcers. Thus, treatment with crushed budesonide (9 mg/day) was started. EGD revealed healing of the duodenal ulcers seven months after treatment. To our knowledge, this is the first report describing EGE-associated duodenal ulcer successfully treated with crushed budesonide.
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Affiliation(s)
- Kimitoshi Kubo
- Departments of Gastroenterology, National Hospital Organization Hakodate National Hospital, Japan
| | - Noriko Kimura
- Departments of Pathology, National Hospital Organization Hakodate National Hospital, Japan
| | - Katsuhiro Mabe
- Departments of Gastroenterology, National Hospital Organization Hakodate National Hospital, Japan
| | - Soichiro Matsuda
- Departments of Gastroenterology, National Hospital Organization Hakodate National Hospital, Japan
| | - Momoko Tsuda
- Departments of Gastroenterology, National Hospital Organization Hakodate National Hospital, Japan
| | - Mototsugu Kato
- Departments of Gastroenterology, National Hospital Organization Hakodate National Hospital, Japan
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Jia N, Tang Y, Li Y. Rare malignant ulcer related to primary intestinal diffuse large B-cell lymphoma: A case report. Medicine (Baltimore) 2020; 99:e18590. [PMID: 32028388 PMCID: PMC7015566 DOI: 10.1097/md.0000000000018590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE The specific pathogenesis of the diffuse large B-cell lymphoma(DLBCL)is still indefinite and argumentative. It is known that DLBCL is the most common type of non-Hodgkin's lymphomas (NHL). A lot of cases of DLBCL such as primary gastric diffuse large B-cell lymphoma(PG-DLBCL) are reported. However, primary intestinal diffuse large B-cell lymphoma(PI-DLBCL) is unusual. PATIENT CONCERNS We present a case of a 57-year-old male diagnosed in the Gastroenterology Department, which presented a bleeding duodenal ulcer with irregular borders. DIAGNOSES The immunohistochemical staining showed: CD20(+++), CD10(+) and Ki-67>40%. INTERVENTIONS The patient was successfully treated by Poly-chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vindesine and prednisolone). OUTCOMES After 6 courses of chemotherapy treatment, the duodenal ulcer was completely healed by reviewing the UGIE. LESSONS Our report might give further strength to avoiding the erroneous and missed diagnosis for PI-DLBCL which is different from common duodenal ulcer.
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Affiliation(s)
- Ning Jia
- Department of Gastroenterology, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine
| | - Yanping Tang
- Department of Gastroenterology, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine
| | - Yang Li
- Department of Diabetes, Tianjin Nankai District Hospital of Traditional Chinese Medicine, Tianjin, China
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Fatahi G, Talebi Bezmin Abadi A, Peerayeh SN, Forootan M. Carrying a 112 bp-segment in Helicobacter pylori dupA may associate with increased risk of duodenal ulcer. Infect Genet Evol 2019; 73:21-25. [PMID: 30981881 DOI: 10.1016/j.meegid.2019.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 02/07/2023]
Abstract
The discovery of Helicobacter pylori in 1983 challenged researchers around the world to identify this pathogen's major virulence factors. The main rationale for this kind of research was to identify a biomarker associated with specific diseases following H. pylori colonization. Among different investigated virulence factors, duodenal ulcer promoting gene A (dupA) has been found to be associated with duodenal ulcer (DU), but its effect was different in various geographical regions. To determine the prevalence of dupA, we applied both classic primer pairs and our newly developed primers producing a highly conserved segment in PCR method. In our survey, 143 (47%) H. pylori isolates were obtained from 304H. pylori-colonized individuals [age range of 19-92; 113 (37%) males with the mean age of 50 and 191 (63%) females with the mean age of 49]. The presence of the dupA gene was investigated by using the different specific primers. The prevalence of the 112 bp segment isolated from H. pylori strains recovered from DU, GU and atrophy groups were significantly higher (81%, p value = .002, 64%, p = .065, 68% and p = .047 38%, respectively) than our control group, where the prevalence of the 112 bp segment was only 38%. Interestingly, a significant relationship was observed between the occurrence of DU and the presence of the 112 bp segment [p = .002; OR: 6.98; (95% CI: 1.94-25.00)]. Taken as a whole, we believe the 112 bp region of H. pylori dupA may serve as the first detected biomarker for the early detection of DU in patients admitted to hospitals.
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Affiliation(s)
- Golzar Fatahi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Amin Talebi Bezmin Abadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Shahin Najar Peerayeh
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mojgan Forootan
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Molina-Castro S, Garita-Cambronero J, Malespín-Bendaña W, Une C, Ramírez V. Virulence factor genotyping of Helicobacter pylori isolated from Costa Rican dyspeptic patients. Microb Pathog 2019; 128:276-280. [PMID: 30654009 DOI: 10.1016/j.micpath.2019.01.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Costa Rica is one of the countries with the highest incidence and mortality rates for gastric cancer. Helicobacter pylori infection rates are high in the whole country. We have previously shown that H. pylori CagA+ is significantly associated with atrophic gastritis (AG) of the antrum in a dyspeptic population. The aim of this work is to determine if other H. pylori virulence factors (vacA, dupA, oipA, iceA and babA2) are associated with atrophic gastritis (AG) or duodenal ulcer (DU). METHODS The presence of virulence genes in Costa Rican H. pylori isolates was analyzed by PCR in 151 cultured strains from patients with dyspeptic symptoms. Endoscopic and histopathological diagnoses were available. Odds-ratio and 95% confidence intervals for AG patients vs. non-atrophic gastritis (NAG) or DU patients vs. no duodenal ulcer (NDU) patients were calculated. RESULTS Amongst the studied isolates, 82% had the cagA+, 76.2% had the vacA s1m1, 97.0% had the oipA+, 21.0% had the icea1, 79.0% had the iceA2, 44.0% had the babA2+ and 76.0% the dupA+ genotypes. Infection with H pylori cagA+, dupA+, oipA+, iceA, babA2+, and vacA s1m1 genotypes was not associated with AG risk. The frequency of the dupA gene was 78.7 and 60.9% in isolates from patients with NDU and DU, respectively, and its presence was significantly associated with decreased risk of duodenal ulcer [odds-ratio: 0.33, p = 0.024, confidence interval 95% (0.11-0.85)]. CONCLUSION H. pylori dupA genotype is inversely associated with DU risk in this population.
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Affiliation(s)
- Silvia Molina-Castro
- Institute for Health Research (INISA), University of Costa Rica, San Pedro, 11501, San José, Costa Rica; School of Medicine, University of Costa Rica, San Pedro, 11501, San José, Costa Rica.
| | - Jerson Garita-Cambronero
- Institute for Health Research (INISA), University of Costa Rica, San Pedro, 11501, San José, Costa Rica.
| | - Wendy Malespín-Bendaña
- Institute for Health Research (INISA), University of Costa Rica, San Pedro, 11501, San José, Costa Rica.
| | - Clas Une
- Institute for Health Research (INISA), University of Costa Rica, San Pedro, 11501, San José, Costa Rica.
| | - Vanessa Ramírez
- Institute for Health Research (INISA), University of Costa Rica, San Pedro, 11501, San José, Costa Rica.
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Min JY, Min KB. Cumulative exposure to nighttime environmental noise and the incidence of peptic ulcer. Environ Int 2018; 121:1172-1178. [PMID: 30366660 DOI: 10.1016/j.envint.2018.10.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/17/2018] [Accepted: 10/17/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Exposure to noise poses auditory and non-auditory effects on health. The gastrointestinal tract is considered as the site of adverse reactions to noise-induced stress; little attention has been paid to a potential link between noise and peptic ulcers. OBJECTIVES The aim of this study was to investigate whether cumulative exposure to environmental noise affects the incidence of peptic ulcer in adults. METHODS We analyzed the data from the National Health Insurance Service-National Sample Cohort (2002-2013). The final study sample comprised 217,308 adults assessed for gastric ulcer and 249,514 adults assessed for duodenal ulcer. The diagnosis of gastric (ICD-10: K25) and duodenal (ICD-10: K26) ulcers during an 8-year follow-up (2006-2013). Environmental noise data was obtained from the National Noise Information System, a nationwide monitors system of noise. RESULTS During the follow-up period, gastric ulcers occurred in 32.1% subjects and duodenal ulcers occurred in 10.7% subjects. The rate of diagnosis for gastric and duodenal ulcers was increased with the increases in cumulative mean levels of nighttime environmental noise. With increases in the increase in interquartile range (IQR) of nighttime noise, the hazard ratio (HR) was significantly increased by 12% (HR = 1.12; 95% CI, 1.10-1.13) for gastric ulcer and 17% (HR = 1.17; 95% CI, 1.15-1.20) for duodenal ulcer based on the fully adjusted model. CONCLUSION Our finding supports previous reports on the damaging effect of environmental noise on the gastrointestinal tract and suggests that cumulative exposure to environmental nighttime noise affects the development of peptic ulcers.
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Affiliation(s)
- Jin-Young Min
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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8
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Abstract
The haemolytic uraemic syndrome (HUS) is a well recognized cause of acute renal failure in children. Gastrointestinal involvement is common, and may result in rectal bleeding which can be an important presenting symptom. Previous publications have stressed the importance of correct diagnosis to avoid unnecessary surgery. Occasionally serious gastrointestinal complications do occur. We present five children with life-threatening gastrointestinal complications of the HUS and discuss the indications for laparotomy.
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Affiliation(s)
- D C Crabbe
- Department of Paediatric Surgery, St James' University Hospital, Leeds
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9
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Abstract
Whilst the association between smoking and peptic ulceration has been reported previously, the relationship between smoking and the complications of ulcers, such as perforation, bleeding or acute painful exacerbation, has not been examined. In a retrospective study comparing 275 emergency admissions for peptic ulcer with 275 controls, cigarette smoking was significantly more common only in those with a perforated duodenal ulcer. Of 128 patients with perforated duodenal ulcers, 110 (86%) were cigarette smokers compared with 65 (51%) of the 128 matched controls (χ2, P<0.01). Cigarette smoking in patients with bleeding or acutely exacerbated ulcers was not significantly more common than in controls. These findings strongly suggest a particular association between smoking and perforated duodenal ulcer.
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Affiliation(s)
- F Smedley
- Surgical Unit, St Stephen's Hospital, London
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10
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Komar OM, Kizlova NM, Trylevych OD, Kravchenko VV. [Risk factors for adverse course of gastric and duodenal peptic ulcer]. Wiad Lek 2018; 71:160-164. [PMID: 29602925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Introduction: High morbidity rate, frequent relapses, and significant economic losses give reasons for highlighting the peptic ulcer disease as the most topical medical-statistical problem. The aim of the study is to assess the influence of the main risk factors on the course of gastric and duodenal peptic ulcer. PATIENTS AND METHODS Materials and methods: We formed up the risk groups consisted of patients with 12 modified (4) and regular (8) factors, each characterized with its own signs and gradations. We performed the quantitative evaluation of the factors and scored the signs thereof, the results of which were used for determination of the most informative ones. RESULTS Results: Among the regular factors, we placed emphasis on gender, age, burdened heredity, and 0(I), Rh+ blood type. The risk of peptic ulcer in hereditary tainted young men of the working age with parental lineage (+2.3) and in males with 0(I) Rh+ blood type (+1.4) was proved. Helicobacter pylori (Hp) infection is a key contributor (a predictor of) to severity of the disease course (+9.7) among the modified risk factors. Negative effect of a concomitant pathology (+5.0), including hepatobiliary lesions (+3.8), hypertension (+4.0), and diabetes mellitus (+1.3) is also significant. Diet violation (+3.7), tobacco smoking (+3.2) and stress (+3.0) were ranked third. CONCLUSION Conclusions: The results of quantitative evaluation of the factors scoring suggest of the underlying H.pylori infection (the significance of which is growing along with the growth of the disease incidence) and irrational diet as the most informatively important ones. We have established the direct dependence between the most important peptic ulcer risk factors, severity of the disease, and duration and periodicity of treatment thereof.
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Affiliation(s)
- Olena M Komar
- Department Of Public Health, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Nataliya M Kizlova
- Department Of Public Health, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Oleksandra D Trylevych
- Department Of Gastroenterology, Vinnytsya Regional Clinical Hospital Named After M. I. Pirogov, Vinnytsya, Ukraine
| | - Vasyl V Kravchenko
- Department Of Public Health Management, Shupik National Medical Academy Of Postgraduate Education, Kiev, Ukraine
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Chen B, Yang Z, Lu H, Wei C, Wang F, Liu C. Eosinophilic gastroenteritis presenting as upper gastrointestinal hematoma and ulcers after endoscopic biopsy: A case report and literature review. Medicine (Baltimore) 2017; 96:e8075. [PMID: 28906408 PMCID: PMC5604677 DOI: 10.1097/md.0000000000008075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Eosinphilic gastroenteritis (EG) is a gastrointestinal disorder characterized by eosinophilic infiltration with various manifestations. The diagnosis is usually confirmed by an endoscopic biopsy, which is considered a safe and routine procedure for the majority. PATIENT CONCERNS We report a 54-year-old male who was presented with intermittent periumbilical pain and melena, and only revealed verrucous gastritis by endoscopy. DIAGNOSES The patient's condition worsened two days after the endoscopic biopsy, and another endoscopy found hematoma and ulcers in upper gastrointestinal tract. He was diagnosed with EG by the pathological analysis of biopsy specimen. INTERVENTIONS Oral methylprednisolone and Montelukast were prescribed. OUTCOMES The patient got remission after initiation of the treatment. LESSONS This case highlights an extremely rare but potentially severe complication of endoscopic biopsies in patients with EG. Physicians should be cautious with hematoma or ulceration, and consider it in such patients who undergo this procedure.
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Affiliation(s)
- Biqin Chen
- Department of Gastroenterology and Hepatology, Jinling Hospital, School of Medicine, Southern Medical University
| | - Zhao Yang
- Department of Gastroenterology and Hepatology, Jinling Hospital, School of Medicine, Southern Medical University
| | - Heng Lu
- Department of Gastroenterology and Hepatology, Jinling Hospital
| | - Cheng Wei
- Department of Gastroenterology and Hepatology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Fangyu Wang
- Department of Gastroenterology and Hepatology, Jinling Hospital, School of Medicine, Southern Medical University
| | - Chang Liu
- Department of Gastroenterology and Hepatology, Jinling Hospital
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12
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Lim CH, Benjamin NHS, Kan FK. Upper gastrointestinal haemorrhage in severe dengue: To scope or not to scope? Med J Malaysia 2017; 72:55-57. [PMID: 28255142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Upper gastrointestinal haemorrhage (UGIH) in severe dengue represents a clinical dilemma in term of management. The recommended treatment in dengue with UGIH involves blood product transfusion support and proton pump inhibitor (PPI) infusion. Despite being the mainstay of treatment in non-dengue UGIH, the role of endoscopic haemostatic intervention in severe dengue remains controversial. In the present report, we present a case of severe dengue complicated with upper gastrointestinal haemorrhage successfully underwent early therapeutic endoscopic intervention in a district hospital.
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Affiliation(s)
- C H Lim
- Hospital Segamat, Department of Surgery, KM 6, Jalan Genuang, 85000 Segamat, Johor, Malaysia.
| | | | - F K Kan
- Hospital Sultanah Aminah, Medical Department, Infectious Disease Unit, Johor Bahru, Johor, Malaysia
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Martino T, Melchionda D, Tonti P, De Francesco V, Lalla A, Specchio LM, Avolio C. Weight loss and decubitus duodenal ulcer in Parkinson’s disease treated with levodopa–carbidopa intestinal gel infusion. J Neural Transm (Vienna) 2016; 123:1395-1398. [PMID: 27614656 DOI: 10.1007/s00702-016-1618-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 09/04/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Tommaso Martino
- SC Neurologia Universitaria-AOU Ospedali Riuniti of Foggia, Foggia, Italy.
| | - Donato Melchionda
- SC Neurologia Universitaria-AOU Ospedali Riuniti of Foggia, Foggia, Italy
| | - Paolo Tonti
- Gastroenterology Unit-AOU Ospedali Riuniti of Foggia, Foggia, Italy
| | | | - Alessandra Lalla
- SC Neurologia Universitaria-AOU Ospedali Riuniti of Foggia, Foggia, Italy
| | | | - Carlo Avolio
- SC Neurologia Universitaria-AOU Ospedali Riuniti of Foggia, Foggia, Italy
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Fujikawa K, Endo Y, Mizokami A, Takahashi K, Tabuchi M, Ohba K, Nakamura H, Kawakami A. Successful Treatment with Adalimumab for Intestinal Behcet's Disease during Pregnancy. Intern Med 2016; 55:1375-8. [PMID: 27181551 DOI: 10.2169/internalmedicine.55.6590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 36-year-old Japanese woman with intestinal Behcet's disease was admitted to our hospital due to a recurrent ileocecal ulcer. Because infliximab (IFX) showed secondary failure, IFX was switched to adalimumab (ADA). After the third injection of ADA, she was unexpectedly 4-weeks pregnant. ADA was continued until 20 gestational weeks. Remission of the disease activity was maintained during pregnancy, and the birth was uneventful. The ileocecal ulcer disappeared after her delivery. ADA was detected in the umbilical blood after 119 days from the last infusion. The placental transition and timing of neonatal vaccination should be considered in cases of pregnancy with TNF antibody therapy.
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Affiliation(s)
- Keita Fujikawa
- Department of Rheumatology, Japan Community Healthcare Organization (JCHO), Isahaya General Hospital, Japan
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15
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Whealon SR, Gibbs LM. Help Desk Answers: What is the optimal duration of PPI therapy for healing an ulcer? J Fam Pract 2015; 64:805-813. [PMID: 26845003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Steven R Whealon
- Saint Louis University Family Medicine Residency, Belleville, IL, USA
| | - Lawrence M Gibbs
- Saint Louis University Family Medicine Residency, Belleville, IL, USA
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16
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Riggle KM, Wahbeh G, Williams EM, Riehle KJ. Perforated duodenal ulcer: An unusual manifestation of allergic eosinophilic gastroenteritis. World J Gastroenterol 2015; 21:12709-12712. [PMID: 26640348 PMCID: PMC4658626 DOI: 10.3748/wjg.v21.i44.12709] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/04/2015] [Accepted: 09/02/2015] [Indexed: 02/06/2023] Open
Abstract
Spontaneous perforation of a duodenal ulcer secondary to allergic eosinophilic gastroenteritis (EGE) has not been previously reported. We present such a case in a teenager who presented with peritonitis. After exploration and operative repair of his ulcer, he continued to experience intermittent abdominal pain, and further evaluation revealed eosinophilic gastroenteritis in the setting of multiple food allergies. His EGE resolved after adhering to a restrictive diet. Both duodenal ulcers and EGE are very rarely seen in pediatric patients. EGE has a variable presentation depending on the layer(s) of bowel wall affected and the segment of the gastrointestinal tract that is involved. Once diagnosed, it may respond to dietary changes in patients with recognized food allergies, or to steroids in patients in whom an underlying cause is not identified. Our case highlights the need to keep EGE in the differential diagnosis when treating pediatric patients with duodenal ulcers. The epidemiology, pathophysiology, and treatment of EGE are also discussed, along with a review of the current literature.
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17
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Okimoto T, Kodama M, Murakami K. [The drugs for H. pylori eradication therapy]. Nihon Rinsho 2015; 73:1169-1174. [PMID: 26165075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
H. pylori eradication significantly inhibited ulcer recurrence in Japanese peptic ulcer patients. In Japan, 12 months after treatment, gastric ulcers had recurred in 11.4% of those with successful H. pylori eradication and 64.5% of those with unsuccessful H. pylori eradication. Duodenal ulcers had recurred in 6.8% of patients for whom H. pylori eradication was successful and in 85.3% of patients in whom eradication failed. About long-term study, 4 years after treatment, gastric ulcers had recurred in 9.3% of those with successful H. pylori eradication and duodenal ulcers recurrence was occurred in 6.2% of those. The annual recurrence rates of gastric, duodenal ulcer were 2.3% and 1.6%, respectively. However, in current Japan, the decrease of the primary eradication rate is reported by the increase of clarithromycin-resistant strains. The increase of metronidazole-resistant strains used for the second eradication is not recognized so far, but in future, increase is concerned about. Therefore, the making of the regimen of the third-line eradication therapy is needed now.
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Matsui S, Kashida H, Asakuma Y, Sakurai T, Kudo M. [Gastric ulcer, duodenal ulcer]. Nihon Rinsho 2015; 73:1116-1122. [PMID: 26165067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Recently, the acid secretion amount is increased by westernization of foods and Helicobacter pylori (H. pylori) infected patient's decrease in Japanese. Therefore, the recent tendencies are decrease of peptic ulcer diseases by H. pylori infection and increase of non-steroidal anti-inflammatory drugs(NSAIDs) ulcers. The endoscopic hemostasis should be performed for upper gastrointestinal bleeding from peptic ulcers in the first choice. A surgery or interventional radiology (IVR) should be performed in the unsuccessfulness of endoscopic hemostasis. H. pylori eradication therapy is effective for healing and prevention of recurrence from peptic ulcers. For prevention of recurrence of NSAIDs ulcers, therapy with proton pump inhibitor is effective.
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Marting A, Defrance P, Wain E, Van Severen M, Deflandre J. [Ulcerated duodenitis revealing Henoch-Schönlein purpura]. Rev Med Liege 2015; 70:384-389. [PMID: 26376566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Inflammation and duodenal ulcers can meet many etiologies. We report the case of a young adult with an ulcerated duodenitis revealing Henoch-Schönlein purpura. The abdominal symptoms preceded the emergence of the classical cutaneous signs of the disease.
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Farzaei MH, Abdollahi M, Rahimi R. Role of dietary polyphenols in the management of peptic ulcer. World J Gastroenterol 2015; 21:6499-6517. [PMID: 26074689 PMCID: PMC4458761 DOI: 10.3748/wjg.v21.i21.6499] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/22/2015] [Accepted: 04/03/2015] [Indexed: 02/06/2023] Open
Abstract
Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge, with high morbidity and death rates for the disease. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proinflammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols. In conclusion, administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.
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Tovey FI. Role of dietary phospholipids and phytosterols in protection against peptic ulceration as shown by experiments on rats. World J Gastroenterol 2015; 21:1377-1384. [PMID: 25663757 PMCID: PMC4316080 DOI: 10.3748/wjg.v21.i5.1377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 12/22/2014] [Indexed: 02/06/2023] Open
Abstract
Geographically the prevalence of duodenal ulceration is related to the staple foods in the diet in regions of developing countries where the diet is stable. It is higher in regions where the diet is based on milled rice, refined wheat or maize, yams, cassava, sweet potato, or green bananas, and is lower in regions where the staple diet is based on unrefined wheat or maize, soya, certain millets or certain pulses. Experiments on rat gastric and duodenal ulcer models showed that it was the lipid fraction in staple foods from low prevalence areas that was protective against both gastric and duodenal ulceration, including ulceration due to non-steroidal anti-inflammatory drugs (NSAIDs). It also promoted ulcer healing. The lipid from the pulse, Dolichos biflorus, horse gram which was highly protective was used to identify the fractions with protective activity in the lipid. The protective activity lay in the phospholipid, sterol and sterol ester fractions. In the phospholipid fraction phosphatidyl choline (lethicin) and phosphatidyl ethanolamine (cephalin) were predominant. In the sterol fraction the sub-fractions showing protective activity contained β-sitosterol, stigmasterol, and an unidentified isomer of β-sitosterol. The evidence from animal models shows that certain dietary phospholipids and phytosterols have a protective action against gastroduodenal ulceration, both singly and in combination. This supports the protective role of staple diets in areas of low duodenal ulcer prevalence and may prove to be of importance in the prevention and treatment of duodenal ulceration and management of recurrent ulcers. A combination of phospholipids and phytosterols could also play an important role in protection against ulceration due to NSAIDs.
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Chan DK, Simonetto DA, Hauser SC. 60-year-old man with chronic diarrhea and peptic ulcer disease. Mayo Clin Proc 2015; 90:e1-5. [PMID: 25572206 DOI: 10.1016/j.mayocp.2014.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/12/2014] [Accepted: 05/21/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Daniel K Chan
- Resident in Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN
| | - Douglas A Simonetto
- Fellow in Gastroenterology, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN
| | - Stephen C Hauser
- Adviser to resident and fellow and Consultant in Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
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Imoto A, Masuda D, Okuda A, Takagi W, Onda S, Sano T, Mikami T, Mohamed M, Ogura T, Higuchi K. A Duodenal Ulcer Caused by Pancreatic Ductal Hypertension with Chronic Pancreatitis. Intern Med 2015; 54:3151-5. [PMID: 26666602 DOI: 10.2169/internalmedicine.54.5779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein describe the case of a 67-year-old woman with a duodenal ulcer thought to be caused by elevated pancreatic ductal pressure. The patient complained of continuous upper abdominal pain. Her medical history included idiopathic chronic pancreatitis. Endoscopy revealed a huge duodenal ulcer located on the inferior duodenal angle, which had not been seen on endoscopic retrograde pancreatography two months previously. A combination study using endoscopy and contrast imaging confirmed the relationship between the duodenal ulcer and the pancreatic branch duct. To our knowledge, this is the first case of duodenal ulcer thought to be caused by elevated pancreatic ductal pressure.
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Affiliation(s)
- Akira Imoto
- Second Department of Internal Medicine, Osaka Medical College, Japan
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Gajda M, Kohut M, Wydmański J, Kamińska-Winciorek G. Bleeding gastric metastases from cutaneous melanoma. Pol Merkur Lekarski 2014; 37:235-6. [PMID: 25518580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED 7% of gastrointestinal tract (GIT) involvements with metastatic cutaneous melanoma concerns the stomach. The aim of the study was to describe a rare case of the cutaneous melanoma metastazing to the stomach. MATERIAL AND METHODS . Bearing in mind the rarity of such cases, we present our experiences based on the history of 42-year-old woman, who underwent surgical excision of skin tumour located on the trunk. RESULTS Histopathological examination of the skin tumor led to the diagnosis of melanoma (Clark IV, Breslow 5mm) with ulceration and a number of mitoses 40/10 HPF. PET-CT demonstrated multiple organ dissemination. Patient was admitted to the hospital due to severe, symptomatic anaemia. RBC and FFP transfusions were necessary. Gastroscopy revealed multiple gastric and duodenal ulcers and histopathology confirmed metastatic melanoma. Attempts to achieve endoscopic hemostasis were ineffective due to the extent of lesions. CONCLUSION In the presence of any alarming GIT symptoms or unclear anaemia, any physician treating patient with a history of melanoma should exclude metastatic tumour. Endoscopy may be useful both for the diagnosis and local treatment of gastric metastases and should be routinely and cautiously conducted.
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Shiota S, Suzuki R, Matsuo Y, Miftahussurur M, Tran TTH, Binh TT, Yamaoka Y. Helicobacter pylori from gastric cancer and duodenal ulcer show same phylogeographic origin in the Andean region in Colombia. PLoS One 2014; 9:e105392. [PMID: 25121764 PMCID: PMC4133377 DOI: 10.1371/journal.pone.0105392] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/23/2014] [Indexed: 12/15/2022] Open
Abstract
Background A recent report has shown that the phylogenetic origin of Helicobacter pylori based on multi-locus sequence typing (MLST) was significantly associated with the severity of gastritis in Colombia. However, the potential relationship between phylogenetic origin and clinical outcomes was not examined in that study. If the phylogenetic origin rather than virulence factors were truly associated with clinical outcomes, identifying a population at high risk for gastric cancer in Colombia would be relatively straightforward. In this study, we examined the phylogenetic origins of strains from gastric cancer and duodenal ulcer patients living in Bogota, Colombia. Methods We included 35 gastric cancer patients and 31 duodenal ulcer patients, which are considered the variant outcomes. The genotypes of cagA and vacA were determined by polymerase chain reaction. The genealogy of these Colombian strains was analyzed by MLST. Bacterial population structure was analyzed using STRUCTURE software. Results H. pylori strains from gastric cancer and duodenal ulcer patients were scattered in the phylogenetic tree; thus, we did not detect any difference in phylogenetic distribution between gastric cancer and duodenal ulcer strains in the hpEurope group in Colombia. Sixty-six strains, with one exception, were classified as hpEurope irrespective of the cagA and vacA genotypes, and type of disease. STRUCTURE analysis revealed that Colombian hpEurope strains have a phylogenetic connection to Spanish strains. Conclusions Our study showed that a phylogeographic origin determined by MLST was insufficient for distinguishing between gastric cancer and duodenal ulcer risk among hpEurope strains in the Andean region in Colombia. Our analysis also suggests that hpEurope strains in Colombia were primarily introduced by Spanish immigrants.
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Affiliation(s)
- Seiji Shiota
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
| | - Rumiko Suzuki
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
| | - Yuichi Matsuo
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
| | - Muhammad Miftahussurur
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
| | - Trang Thu Huyen Tran
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
| | - Tran Thanh Binh
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
- Department of Medicine-Gastroenterology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail:
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Cherniaevskaia GM, Maksimenko GV, Beloborodova ÉI, Ustiuzhanina EA, Denisova OA. [Clinical and morphological peculiarities of the clinical course of duodenal ulcer in patients with bronchial asthma]. Klin Med (Mosk) 2014; 92:47-52. [PMID: 25269182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This work was aimed to study clinical features of H. pylori-associated duodenal ulcer (DU) and elucidate morphological features of gastric mucosa (GM) in patients with bronchial asthma (BA). Simultaneous prospective examination of 118 patients aged 18-64 yr included clinical and endoscopic study of the gastroduodenal region with the assessment of gastroenterological symptoms and morphological analysis of GM and duodenal biopsies by histological, histochemical, and morphometric methods. It was shown that GM inflammation in patients with DU and BA is associated not only with H. pylori infection but also with the phase of BA. Structural changes of GM in the patients with DU and BA, unlike those with DU without BA, were apparent not only in the antrum but also in the fundus. Growing density of eosinophil, neutrophil and mast cell infiltration of fundal and antral GM as well as increased total number of cells in the antrum reflects active immune-mediated inflammation in GM lamina propria. It is concluded that negative effect of uncontrolled BA on the clinical course of DU is not restricted to the association of DU exacerbation with the absence of BA control; it is also responsible for enhanced activity of gastritis. One of the possible factors determining combination of H. pylori-associated duodenal ulcer with BA is chronic hyperergic inflammation and marked structural changes in GM.
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Karapetian TA, Nikiforova NA, Dorshakova NV, Vinogradova IA. [Peculiarities of clinical picture of duodenal ulcer in the population of Northern Europe]. Klin Med (Mosk) 2014; 92:13-19. [PMID: 25269204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Duodenal ulcer remains a serious challenge to gastroenterology due to the difficulty of its management despite recent progress in this field. The role of melatonin in human body has attracted much attention of researchers in the recent years. Disturbances of its production are widely recognized to be involved in pathogenesis of duodenal ulcer and its exacerbation. This review summarizes results of research on the clinical picture of the disease in the population of European North where circadian and seasonal variations in melatonin production are most strongly pronounced.
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Etonyeaku AC, Agbakwuru EA, Akinkuolie AA, Omotola CA, Talabi AO, Onyia CU, Kolawole OA, Aladesuru OA. A review of the management of perforated duodenal ulcers at a tertiary hospital in south western Nigeria. Afr Health Sci 2013; 13:907-13. [PMID: 24940311 PMCID: PMC4056487 DOI: 10.4314/ahs.v13i4.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Gastro-duodenal perforations are common and may complicate peptic ulcer disease. Management is often by surgical closure. OBJECTIVE To determine the patterns of presentation and mode of management of duodenal ulcer perforations. METHODS Retrospective review of patients with duodenal ulcer perforations seen at the Obafemi Awolowo University Teaching Hospital between June 2001 and July 2011. Patients' records were reviewed for demography, duration of disease, probable risk factors, type of surgery and complications. Data obtained was analyzed using SPSS 15.0. RESULT Forty- five patients were reviewed. There were 37 males (82.2%). Mean age was 39.7years (range 15-78years). There were 10 (22.6%) students and 8(17.8%) farmers. NSAIDs abuse (11), previous peptic ulcer disease (2), and no prior dyspeptic symptoms (20) constituted 24.4%, 4.4% and 44.4% respectively of cases. Seven (16%) patients presented less than 24 hours of onset of illness. Forty one perforations (91.1%) involved the first part of duodenum. Twenty two (49%) patients had Graham's omental patch. We had one (2.2%) failed repair and six (13.3%) mortalities. CONCLUSION Late presentation of duodenal ulcer perforation is common with high mortality. Pragmatic surgical intervention with Graham's omentopexy with broad spectrum antibiotics is still commonly practiced.
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Affiliation(s)
- A C Etonyeaku
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - E A Agbakwuru
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - A A Akinkuolie
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - C A Omotola
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - A O Talabi
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - C U Onyia
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - O A Kolawole
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - O A Aladesuru
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
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Matsuda K, Tanikawa C, Nakamura Y. [Possible role of genetic factors on reduced risk for gastric cancer among duodenal ulcer patients]. Nihon Rinsho 2013; 71:1491-1496. [PMID: 23967685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although H. pylori causes both gastric cancer and peptic ulcer, duodenal ulcer patients were known to have low risk for gastric cancer. Recently the association of PSCA and ABO with duodenal ulcer were identified by GWAS in the Japanese population. A T-allele of SNP rs2294008 in the PSCA promoter creates the upstream translational initiation codon and affects the protein localization from cytoplasm to cell surface. A T-allele of SNP rs2294008 increased gastric cancer risk but reduced duodenal ulcer risk. In addition, blood type O was shown to increase risk for duodenal ulcer, while blood type A was associated with gastric cancer risk in the Caucasian population. Our finding would partially explain low risk of gastric cancer among duodenal ulcer patients.
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Miyamoto M, Haruma K. [Gastric ulcer and duodenal ulcer]. Nihon Rinsho 2013; 71:1418-1423. [PMID: 23967673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Peptic ulcer diseases are improved by strong acid suppression therapy. However, peptic ulcer diseases are often relapsed after discontinuing of acid suppression therapy. After discovery of Helicobacter pylori (H. pylori) in 1984, H. pylori is known as the strongest causal agent for peptic ulcer diseases. In November 2000, eradication therapy for H. pylori infection was approved under the Japanese system of health insurance. H. pylori eradication reduces ulcer recurrence dramatically. Recently, peptic ulcer diseases induced by NSAIDs and/or aspirin are increasing. In prevention of NSAIDs and/or aspirin induced peptic ulcer recurrence, H. pylori eradication plus PPI treatment is recommended. Several reports described occurrence of newly-developed gastric cancer after H. pylori eradication. Careful follow-up upper gastrointestinal endoscopy is necessary after H. pylori eradication.
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Affiliation(s)
- Masaki Miyamoto
- Department of General Internal Medicine, Hiroshima Prefectural Hospital
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Guardado-Bermúdez F, Ardisson-Zamora FJ, Rojas-González JD, Medina-Benítez A, Corona-Suárez F. [Perforated duodenal diverticula. Case report and treatment options]. CIR CIR 2013; 81:340-347. [PMID: 25063900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND the presence of duodenal diverticula was first described in 1710 by Chromel. Duodenal diverticulum is the second most common site of diverticula in the digestive tract. Anatomically duodenal diverticula are located in 10 to 67% in the second portion of duodenum, and its finding in most cases incidental. About 90% of patients appear asymptomatic, manifesting symptoms mostly once established complications such as: gastrointestinal bleeding and perforation. CLINICAL CASE 78-years-old woman who attended our Emergency department with dyspnea, moderate epigastralgia, abdominal bloating, constipation and difficulty to pass gas; Laparotomy was performed to identify duodenal diverticulum in the third portion of the duodenum with a perforation of 5 mm in its cupula. It proceeds with diverticulectomy. CONCLUSIONS The diagnosis of duodenal diverticulum as a cause of acute abdomen must be considered in our differential diagnosis in acute abdomen supported by imaging and endoscopy. The surgical management of duodenal diverticulum, in particular the resection of the diverticulum, remains as the recommendation for treatment with less morbidity and a good recovery.
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Affiliation(s)
| | | | | | - Alberto Medina-Benítez
- Servicio de Cirugía General. Departamento de Cirugía del Hospital Regional de Cd. Madero PEMEX, Mexico.
| | - Fernando Corona-Suárez
- Servicio de Cirugía General. Departamento de Cirugía del Hospital Regional de Cd. Madero PEMEX, Mexico
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Yoon H, Oh D, Park HC, Kang SW, Han Y, Lim DH, Paik SW. Predictive factors for gastroduodenal toxicity based on endoscopy following radiotherapy in patients with hepatocellular carcinoma. Strahlenther Onkol 2013; 189:541-6. [PMID: 23703401 DOI: 10.1007/s00066-013-0343-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 03/06/2013] [Indexed: 12/25/2022]
Abstract
PURPOSE The aim of this work was to determine predictive factors for gastroduodenal (GD) toxicity in hepatocellular carcinoma (HCC) patients who were treated with radiotherapy (RT). PATIENTS AND METHODS A total of 90 HCC patients who underwent esophagogastroduodenoscopy (EGD) before and after RT were enrolled. RT was delivered as 30-50 Gy (median 37.5 Gy) in 2-5 Gy (median 3.5 Gy) per fraction. All endoscopic findings were reviewed and GD toxicities related to RT were graded by the Common Toxicity Criteria for Adverse Events, version 3.0. The predictive factors for the ≥ grade 2 GD toxicity were investigated. RESULTS Endoscopic findings showed erosive gastritis in 14 patients (16 %), gastric ulcers in 8 patients (9 %), erosive duodenitis in 15 patients (17 %), and duodenal ulcers in 14 patients (16 %). Grade 2 toxicity developed in 19 patients (21 %) and grade 3 toxicity developed in 8 patients (9 %). V25 for stomach and V35 for duodenum (volume receiving a RT dose of more than x Gy) were the most predictive factors for ≥ grade 2 toxicity. The gastric toxicity rate at 6 months was 2.9 % for V25 ≤ 6.3 % and 57.1 % for V25 > 6.3 %. The duodenal toxicity rate at 6 months was 9.4 % for V35 ≤ 5.4 % and 45.9 % for V35 > 5.4 %. By multivariate analysis including the clinical factors, V25 for stomach and V35 for duodenum were the significant factors. CONCLUSION EGD revealed that GD toxicity is common following RT for HCC. V25 for the stomach and V35 for the duodenum were the significant factors to predict ≥ grade 2 GD toxicity.
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Affiliation(s)
- H Yoon
- Department of Health Sciences and Technology, School of Medicine & Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
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Rodríguez-Lago I, Carretero C, Herráiz M, Subtil JC, Betés M, Rodríguez-Fraile M, Sola JJ, Bilbao JI, Muñoz-Navas M, Sangro B. Long-term follow-up study of gastroduodenal lesions after radioembolization of hepatic tumors. World J Gastroenterol 2013; 19:2935-2940. [PMID: 23704826 PMCID: PMC3660818 DOI: 10.3748/wjg.v19.i19.2935] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 02/06/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the long-term natural history of the gastroduodenal lesions secondary to extrahepatic embolization with Ytrium 90 (90Y) spheres.
METHODS: From September 2003 to January 2012, 379 procedures of liver radioembolization (RE) using resin microspheres loaded with 90Y were performed in our center. We have retrospectively compiled the data from 379 RE procedures performed in our center. We report a comprehensive clinical, analytical, endoscopic and histologic long-term follow-up of a series of patients who developed gastroduodenal lesions after the treatment.
RESULTS: Six patients (1.5%) developed gastrointestinal symptoms and had gastrointestinal lesions as shown by upper endoscopy in the next 12 wk after RE. The mean time between RE and the appearance of symptoms was 5 wk. Only one patient required endoscopic and surgical treatment. The incidence of gastrointestinal ulcerations was 3.75% (3/80) when only planar images were used for the pre-treatment evaluation. It was reduced to 1% (3/299) when single-photon emission computed tomography (SPECT) images were also performed. The symptoms that lasted for a longer time were nausea and vomiting, until 25 mo after the treatment.
CONCLUSION: All patients were free from severe symptoms at the end of follow-up. The routine use of SPECT has decreased the incidence of gastrointestinal lesions due to unintended deployment of 90Y particles.
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Ouchi A, Isogai M, Harada T, Kaneoka Y, Kamei K, Maeda A. Duodenal ulcer penetration into the superior mesenteric artery after percutaneous transluminal angioplasty and stent placement for acute mesenteric ischemia: report of a case. Surg Today 2013; 44:1552-5. [PMID: 23681599 PMCID: PMC4097201 DOI: 10.1007/s00595-013-0557-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 02/03/2013] [Indexed: 01/16/2023]
Abstract
A 78-year-old male presented with the chief complaints of abdominal pain and vomiting. Contrast-enhanced computed tomography and abdominal angiography showed occlusion of the superior mesenteric artery due to thrombosis, and emergency percutaneous transluminal angioplasty and stent placement were carried out. Two months later, stent thrombosis developed, and a second stent was placed. Eight months later, he complained of general fatigue and anorexia. Gastrointestinal endoscopy revealed a duodenal ulcer at the third portion close to the superior mesenteric artery. Thirteen days after conservative management, duodenal ulcer penetration into the superior mesenteric artery with subsequent air embolism developed, and the patient died of multiple organ failure.
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Affiliation(s)
- Akira Ouchi
- Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan,
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36
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Borodach AV. [Ulcer disease: the state of art]. Khirurgiia (Mosk) 2013:38-42. [PMID: 24300577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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37
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Stepanishcheva LA, Sarsenbaeva AS, Fattakhova NV. [Influence of the comorbidity diseases and risk factors on development of the combined peptic ulcer of the stomach and the duodenum]. Eksp Klin Gastroenterol 2013:34-40. [PMID: 24933946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
RESEARCH OBJECTIVE To define influence of the comorbidity diseases and risk factors of development of the combined peptic ulcer of a stomach and duodenum. MATERIALS AND METHODS As a result of carried-out poll and inspection 250 patients with an exacerbation of a peptic ulcer were surveyed. Patients were distributed in 3 groups of observation depending on localization of ulcerative process. At all surveyed questioning was carried out, data on hereditary load, smoking, alcohol intake, existence of somatopathies were specified, clinic-morphological implications of a peptic ulcer were studied. RESULTS The peptic ulcer of a stomach is characteristic for women (72.1%) and develops mainly aged from 45 till 59 years (60.3%). Peptic ulcer of duodenum men (76.3%) suffer mainly, the debut is the share in most cases of age from 18 to 44 years (79.1%). The combined canker of a stomach and duodenum meets at males (61.2%) more often, is initially involved in process ulcerogenesis by duodenum generally aged from 30 till 44 years (64.2%), accession of a canker of a stomach happens is delayed (at 38.8% within 16 and more years). In the analysis of risk factors at patients with the combined peptic ulcer of a stomach and duodenum depending on existence or absence specific to this category of patients of a background from such comorbidity diseases as IBS, HOBL and widespread osteochondrosis taped that larger prevalence of smoking (100%) and as the use (50%) and the excessive use (50%), alcohol are characteristic for the patients having a high comorbidity (a combination of three above nosologies). CONCLUSION The greatest interest in respect of possible communication with formation of the combined peptic ulcer of a stomach and duodenum is represented by IBS, HOBL and osteochondrosis. And major factors of risk were smoking, the excessive alcohol intake, the burdened heredity.
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Liniker E, Al-Jilaihawi S, Propper D, Slater S, Pacey S. A 46 year old man with carcinoma of unknown primary site. BMJ 2012; 345:e5144. [PMID: 22859798 DOI: 10.1136/bmj.e5144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- E Liniker
- Department of Oncology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
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39
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Toyokawa A. [Overseas business trips that prevent employees from seeking medical care for their chronic conditions]. Rinsho Byori 2012; Suppl 148:103-106. [PMID: 23424741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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40
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Garg M, Strauchen JA, Warner RRP, Divino CM. Radioembolization-induced gastroduodenal ulcer. Am Surg 2012; 78:621-623. [PMID: 22546141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Malika Garg
- Division of General Surgery, Department of Surgery, Mount Sinai School of Medicine, New York, New York, USA
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41
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Kalinkin MN, Osadchiĭ VA, Bukanova TI, Sergeev AN, Rasskazova IV. [Clinic pathogenetic features of gastroduodenal erosions and ulcers in patients with unstable stenocardia]. Eksp Klin Gastroenterol 2012:34-40. [PMID: 23402169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To reveal the clinical, morphological and pathogenic features of gastroduodenal erosions and ulcers in unstable angina. METHODS 135 patients with unstable angina were examined and divided into 2 groups, depending on the presence of a pathological process in the gastroduodenal zone. The state of microcirculation in the tissues of the gastroduodenal zone, secretory and motor function of the stomach were estimated by complex of techniques, adapted to the severity of the patients. RESULTS It is found that the pathological process in the gastroduodenal zone in patients with unstable angina was presented primarily by acute erosions, less - acute ulcers or recurrent peptic ulcer disease. In this case, the leading symptom of acute erosions was dyspepsia, that as a rule prevailed over the indistinct abdominal pain, and often disappeared in the first few days of treatment. Clinical picture of acute ulcers was determined by gastric dyspepsia and was often combined with abdominal pain and symptoms of gastrointestinal bleeding. The recurrence of peptic ulcer disease was characterized by the combination of moderate abdominal pain, often with migration in retrosternal and cardiac area and loss of circadian rhythm inherent in anthro-duodenal ulcer localization, and dyspeptic disorders. The severity of symptoms of ulcerous process was gradually decreased with time, but in most patients, they had remained by the end of the 2nd week of treatment. The basis of development of erosions and ulcers in unstable angina were the focal mainly thrombohaemorrhagic disorders of the terminal blood flow in the gastroduodenal mucosa. Its were combined with changes in the functional state of the stomach, manifested with an increase activity of acid-peptic factor, reduced production of gastromucoproteins, hypomotor dyskinesia and discoordination of anthro-duodenal propulsion on the hypotonic type. CONCLUSION Erosive and ulcerative lesions of gastroduodenal zone in unstable angina have a number of clinical and pathogenetic features that should be considered in the process of diagnosis and treatment.
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Zelickson MS, Bronder CM, Johnson BL, Camunas JA, Smith DE, Rawlinson D, Von S, Stone HH, Taylor SM. Helicobacter pylori is not the predominant etiology for peptic ulcers requiring operation. Am Surg 2011; 77:1054-1060. [PMID: 21944523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
As the number of patients requiring operation for peptic ulcer disease (PUD) declines, presumed contemporary ulcer etiology has largely been derived from medically treated patients not subjected to surgery. The purpose of this study was to examine the specific causes of PUD in patients requiring surgery. Our Acute Care Surgical Service registry was reviewed for patients operated on for complications of PUD from 2004 to 2009. Emphasis was placed on individual etiologic factors for PUD. There were 128 patients (52% male, 81% white) who underwent emergency operation including: simple patch closure (n = 61, 48%); gastric resection (n = 22, 17%); gastric resection with vagotomy (n = 21, 16%); vagotomy and pyloroplasty (n = 18, 14%); or other procedures (n = 6, 5%). Complications necessitating operation were perforation (n = 79, 62%); bleeding (n = 29, 23%); obstruction (n = 12, 9%); and intractability (n = 8, 6%). Perioperative mortality was 12.5 per cent. Risk factors for PUD included tobacco use (50%), alcohol abuse (34%), and steroids (21%). Nonsteroidal anti-inflammatory use was confirmed in 68 (53%) patients. Of the 128 patients, 82 (64%) were tested for Helicobacter pylori, 33 (40%) of which were positive and 49 (60%) negative. Helicobacter pylori, thus, was the confirmed ulcer etiology in only 26 per cent of cases. Unlike contemporary series of medically treated PUD, Helicobacter pylori may not be the predominant etiologic factor in patients who experience complications requiring surgery. A "traditional" surgical approach with liberal use of vagotomy, not antibiotic triple therapy, may well be the preferred treatment consideration in such cases.
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Affiliation(s)
- Marc S Zelickson
- Greenville Hospital System University Medical Center, University of South Carolina, School of Medicine-Greenville, Greenville, South Carolina, USA
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Tubek S, Bunio A, Szyguła R, Krasowski G. The content of elements in rainwater and its relation to the frequency of hospitalization for gastric and duodenal peptic ulcers in Opole Voivodship, Poland, during 2000-2002. Biol Trace Elem Res 2011; 140:253-61. [PMID: 20437109 DOI: 10.1007/s12011-010-8694-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 03/31/2010] [Indexed: 10/19/2022]
Abstract
The relationship between chemical elements in rainwater and the frequency of hospitalizations for gastric and duodenal peptic ulcers was studied on the population of the province (Voivodship) of Opole, Poland, during the years 2000-2002. There is a high positive correlation between hospitalized cases of gastric peptic ulcers with chromium in rainwater (r = 0.71), cadmium (r = 0.63), and lead (r = 0.70). Mild positive correlations were found with zinc (r = 0.55), copper (r = 0.56), iron (r = 0.57), chloride (r = 0.60), and sulfate (r = 0.52). These correlations were higher on men, suggesting that there are gender correlations involved. In duodenal peptic ulcers, we observed a high positive correlation between chromium in rainwater and hospitalized cases (r = 0.61) and mild positive correlations with lead (r = 0.57), copper (r = 0.52), and cadmium (r = 0.51). Significant gender differences were not found. These positive correlations may be due to the biological activity of the elements, such as their cytotoxic activity, enhanced local adrenergic stimulation on mucosal vasculature, ion channel (mainly calcium channels) remodeling, and, for example promoting infection by Helicobacter pylori.
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Affiliation(s)
- Slawomir Tubek
- Department of Internal Diseases, Voivodship Hospital, Opole, Poland.
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Dzhitava IG, Smirnova GO, Martirosov AV. [The new algorithm of diagnostics, prevention and treatment of acute erosive and ulcerative lesions of the gastrointestinal tract]. Eksp Klin Gastroenterol 2011:63-68. [PMID: 21916237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The work presents an analysis of treatment 745 patients with gastrointestinal bleeding from acute ulcers. Algorithm diagnosis and treatment of acute ulcers by different groups of patients. Treatment depends on the nature of secretory activity stomach bleeding risk of relapse and localization ulcers.
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45
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Kolesnikova II, Volkov VS, Liubskaia LA. [Characteristics of duodenogastric reflux in duodenal ulcer patients and its dynamics after Helicobacter pylori eradication]. Eksp Klin Gastroenterol 2011:16-19. [PMID: 21916229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Studying role of duodenogastric reflux (DGR) in pathogenesis and sanogenesis of duodenal ulcer (DU). MATERIAL AND METHODS 233 DU patients (92 patients with a mild, 45--with modern and 96--with the complicated current of disease) are surveyed. Control group were 100 healthy volunteers. Clinical research, endoscopy and 24-hours pH-metria was carried out. In a year after eradication Helicobacter pylori (Hp) 30 patients are repeatedly surveyed. RESULTS at healthy acidity more low, and DGR above and more for a long time, than at DU patients. DU was especially supressed at complicated current DU. Eradication Hp was accompanied by acidity normalization only at mild DU, and at complicated DU--is not present. CONCLUSION at healthy people DGR arises in reply to antrum's acidification and has compensative value, and at DU there is the considerable suppression leading to insufficiency of antrum's alkalization. After eradication Hp normalization DGR is marked only at mild current DU.
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Tsimmerman IS. [The problems of etiology and pathogenesis of ulcer disease: rereading V. Kh. Vasilenko]. Klin Med (Mosk) 2011; 89:14-19. [PMID: 21516758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The author discusses the views of V. Kh. Vasilenko on etiology and pathogenesis of ulcer disease expounded in his last publications and compares them with modern concepts of the origin of this condition. The nature of ulcer disease as a systemic gastrointestinal pathology is considered with special emphasis on its difference from secondary (symptomatic) ulceration, pathogenetic significance of H. pylori infection, hereditary and environmental (non-infectious) factors. Much attention is given to the conditions facilitating the development of ulcer diseases at different combinations of internal and environmental factors including such poorly known ones as immune and sanogenetic mechanisms.
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Selezneva MG, Kolobov SV, Zaĭrat'iants OV, Shevchenko VP, Zarat'iants GO, Ozeritskiĭ AV. [Acute erosive gastropathies]. Arkh Patol 2010; 72:57-60. [PMID: 21313773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
There is a rise in the rates of acute erosive gastropathies in patients with cardiovascular and other somatic diseases. The role of acute erosive gastropathy-induced hemorrhages in the tanatogenesis of these diseases is underestimated; the problems of their prevention, diagnosis, and treatment remained unsolved. Many factors, mainly acute or chronic ischemia of the gastroduodenal mucosa, as well as its age-related involution, Helicobacter pylori infection, reflux gastritis, multiple organ dysfunction, drug-induced damage, etc., which are implicated in the pathogenesis of acute erosive gastropathies in patients with cardiovascular and other somatic diseases, are summarized.
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Affiliation(s)
- N Kalach
- Clinique Pédiatrique Saint-Antoine, Hôpital Saint-Vincent-de-Paul, Université Catholique, Lille, France.
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Chacaltana Mendoza A. [Duodenal involvement in Henoch-Schonlein purpura. Report of a case]. Rev Gastroenterol Peru 2010; 30:220-223. [PMID: 20924430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Henoch-Schonlein purpura (HSP) is a systemic vasculitis of the small vessels of the skin, joints, gastrointestinal tract and kidneys. It is the most common cause of nonthrombocytopenic purpura in children, but may also occur in adults. Gastrointestinal symptoms and disease occurs in up to 85% of patients and can be of varying intensity. We report a 12 year old boy with gastrointestinal bleeding due to duodenal involvement associated with this condition evidenced by endoscopy.
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Kolobov SV, Zaĭrat'iants OV, Selezneva MG, Zaĭrat'iants GO, Khokhlova EE. [Acute gastroduodenal erosions and ulcers in coronary heart disease, cerebrovascular disease, and chronic obstructive pulmonary disease]. Arkh Patol 2010; 72:36-40. [PMID: 21086636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A total of 4684 autopsies made at Moscow multidisciplinary hospitals in 2002-2008 were studied to reveal the incidence and morphological features of acute gastroduodenal erosions and ulcers in coronary heart disease (CHD), cerebrovascular disease (CVD), and chronic obstructive pulmonary disease (COPD). Cases with combined, background, and concomitant diseases that could be independent causes of gastroduodenal lesions were excluded. Patients older than 60 years with infarctions of the myocardium or brain, a concurrence of CHD, CVD, and COPD, and various diseases with chronic heart failure syndrome, particularly in the presence of arterial hypertension and diabetes mellitus should be referred to as a risk group for acute gastroduodenal erosions and ulcers and their induced hemorrhages.
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