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1
Vainshtein, S. G., Z. I. Shust, M. N. Zhukovsky, and Ya N. Fedoriv. "Local treatment of gastroduodenal ulcers." Kazan medical journal 67, no. 6 (November 15, 1986): 403–4. http://dx.doi.org/10.17816/kazmj70743.
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In spite of the established ideas about peptic ulcer as a general disease of the whole organism, there is a continuous flow of publications in which local treatment of ulcers of the mucous membrane of the stomach and duodenum is recommended. With the development of fiber optics, it became possible to target the ulcers, activating reparation processes in them. Adhesives and film-forming compositions MK-6, Lifusol, Gastrovol etc. were used to cover the ulcers.
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Xu, Fang, Cai-ling Mai, and Qian Zhu. "Association of TLR-9 polymorphisms with the development of gastroduodenal ulcer: A hospital-based study in a Chinese cohort." European Journal of Inflammation 16 (January 1, 2018): 1721727X1875726. http://dx.doi.org/10.1177/1721727x18757262.
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Helicobacter pylori infections have been one of the major factors associated with gastroduodenal ulcer. Toll-like receptors (TLRs) of human recognize mycobacterium-induced immune response and protect subjects from disease pathogenesis. Variants in TLR genes are believed to influence immune responses to H. pylori and clinical severity. TLR-9 polymorphisms have been associated with susceptibility to gastroduodenal ulcer in different populations. In this study, we investigate the role of common TLR-9 variants in susceptibility/resistance to the development of gastroduodenal ulcer in a Chinese cohort. The present hospital-based case–control study enrolled 580 patients with abdominal discomfort, and based on endoscopic investigation, the patients were categorized into (1) gastric ulcer (n = 154), (2) duodenal ulcer (n = 70), (3) gastric and duodenal ulcers (n = 25), (4) gastritis (n = 195), and (5) healthy stomach (n = 136). A total of 520 healthy controls from similar geographical areas were enrolled as controls. TLR-9 (C-1237T, C-1486T, and G+2848A) polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Plasma levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β in both healthy controls and patients were quantified by enzyme-linked immunosorbent assay (ELISA). Furthermore, messenger RNA (mRNA) expressions of TNF-α, IL-6, and IL-1β in biopsy tissues were quantified by real-time polymerase chain reaction (RT-PCR). The prevalence of TLR-9+2848 heterozygotes (CT) was significantly higher in gastroduodenal ulcer patients compared to healthy controls. Sub-categorization of patients revealed higher prevalence of heterozygotes of TLR-9 C+2848T and C-1486T polymorphisms in patients with gastric ulcer (GU), duodenal ulcer (DU), and those with both gastric and duodenal ulcers (GDU) when compared to controls. Patients displayed higher plasma cytokine levels than healthy controls. TLR-9 polymorphisms (C+2848T and C-1486T) correlated with altered cytokine expression in biopsy tissues and their plasma levels. In conclusion, TLR-9 (C+2848T and C-1486T) polymorphisms are associated with gastroduodenal ulcer and correlated with altered cytokine levels.
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Ashcroft, Darren M., Stephen R. Chapman, Wendy K. Clark, and David S. Millson. "Upper Gastroduodenal Ulceration in Arthritis Patients Treated with Celecoxib." Annals of Pharmacotherapy 35, no. 7-8 (July 2001): 829–34. http://dx.doi.org/10.1345/aph.10382.
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OBJECTIVE: To evaluate the comparative incidence of endoscopic gastroduodenal ulcers in patients with rheumatoid arthritis or osteoarthritis treated with celecoxib. DESIGN: Quantitative systematic review of randomized controlled trials. SUBJECTS: Patients (n = 4632) with rheumatoid arthritis or osteoarthritis reported in five trials. MAIN OUTCOME MEASURES: Rate ratios, rate differences, and the number needed to harm were calculated for the incidence of endoscopically documented gastroduodenal ulcers. RESULTS: Pooled rate ratios (RRs) relative to placebo for endoscopic ulcers at 12 weeks were 1.96 (95% CI 0.85 to 4.55) for celecoxib 100 mg twice daily and 2.35 (95% CI 1.02 to 5.38) for celecoxib 200 mg twice daily. There was no significant difference in gastroduodenal ulcers at 12 weeks between celecoxib 200 mg twice daily and celecoxib 100 mg twice daily; the corresponding pooled RR was 1.21 (95% CI 0.62 to 2.38). In contrast, celecoxib 200 mg twice daily was associated with a significantly lower rate of gastroduodenal ulcers than was naproxen 500 mg twice daily at 12 weeks (RR 0.24; 95% CI 0.17 to 0.33). On average, for every seven patients treated with naproxen, one more had an endoscopic ulcer than if they were treated with celecoxib. Celecoxib 200 mg twice daily also had a significantly lower risk of endoscopic ulcers than did either modified-release diclofenac 75 mg twice daily at 24 weeks (RR 0.24; 95% CI 0.11 to 0.52) or ibuprofen 800 mg three × daily at 12 weeks (RR 0.30; 95% CI 0.20 to 0.46). CONCLUSIONS: Endoscopic studies have shown that celecoxib, at a wide range of doses, is associated with a lower incidence of gastroduodenal ulcers than are diclofenac, ibuprofen, or naproxen. The incidence rates of gastroduodenal ulcers associated with celecoxib were similar, although not equivalent, to placebo. Head-to-head comparisons suggest that, at the wide range of doses studied (100–800 mg/d), there are no dose-related increases in endoscopic gastroduodenal ulcers with celecoxib. The results of longer term comparative trials of celecoxib based on clinical outcomes are needed to determine celecoxib's ultimate risk—benefit profile.
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Melnyk, I. V., and S. B. Soliev. "The original scale prediction of recurrence risk of gastroduodenal ulcer bleeding." Experimental and Clinical Gastroenterology, no. 2 (April 7, 2021): 72–78. http://dx.doi.org/10.31146/1682-8658-ecg-186-2-72-78.
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Research goal - to examine the effectiveness of active-individualized tactics in treatment of chronic gastric and duodenal ulcers. Material and methods. Analysis of treatment of 251 patients with chronic gastric and duodenal ulcer bleeding was conducted. Duodenal ulcer bleeding was present in 202 cases (80,5%), gastric ulcers were the reason of bleeding in 49 cases (19,5%). Treatment conducted according to principles of active-individualized tactics. Results. The provided characteristics and the acquired results were presented according to the fundamental components of active-individualized tactics in treatment of gastric and duodenal ulcers. Diagnostic and treatment abilities of endoscopy were determined, an unique scale of bleeding relapse risk was presented, the time limits and main indications for surgery were explained,, the role of bleeding relapse was emphasized as crucial in forming the main results of treatment of patients with bleeding gastric and duodenal ulcers. Conclusion. At present time, active-individualized tactics should be used for treatment of gastric and duodenal ulcer bleeding.
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Santos-Rancaño, Rocio, Esteban Martín Antona, and José Vicente Méndez Montero. "A Challenging Case of a Large Gastroduodenal Artery Pseudoaneurysm after Surgery of a Peptic Ulcer." Case Reports in Surgery 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/370937.
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We report a 48-year-old man in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum and gastroduodenal artery causing pseudoaneurysm. The lesion was found and evaluated by contrast-enhanced computed tomography (that revealed a large pseudoaneurysm of 83 mm×75 mm in diameter) and by angiography and then treated with transcatheter embolization leading to a complete resolution of the lesion. The case is rare and important for several reasons. First, we demonstrate that pseudoaneurysm of the gastroduodenal artery caused by a duodenal ulcer can occur and present a diagnostic challenge (as far as we know, only three cases have been reported previously in the literature). Second, this case report focuses on the importance of ligation of the gastroduodenal artery when bleeding of peptic ulcers occurs. Additionally, we present an overview of the relevant literature.
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Spivakovskiy, Yu M., A. Yu Spivakovsky, Yu V. Chernenkov, O. V. Volkova, I. V. Goremykina, and A. K. Dushanova. "The case of atypical course of gastric ulcer in pediatric practice." Experimental and Clinical Gastroenterology, no. 11 (November 20, 2019): 93–99. http://dx.doi.org/10.31146/1682-8658-ecg-171-11-93-99.
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In the article, the authors present brief information about gastric ulcer and duodenal ulcer, its epidemiology, diagnostic capabilities, approaches to the treatment and prevention of complications. In addition, there are data on the diagnosis and verification of symptomatic gastroduodenal ulcers. Using the example of a clinical case of a complicated symptomatic ulcer in a child, the authors describe the difficulties encountered at the stages of diagnosis, treatment, and follow-up at high risk of complications.
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Zherlov, G. K., A. P. Koshel, V. M. Vorobiyov, and Yu D. Yermolayev. "Язвенная болезнь желудка и двенадцатиперстной кишки: выбор тактики при кровотечении." Bulletin of Siberian Medicine 5, no. 1 (March 30, 2006): 76–80. http://dx.doi.org/10.20538/1682-0363-2006-1-76-80.
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Ulcerative gastroduodenal bleedings remain the actual problem of emergency surgery because of quite frequency and high mortality. The analysis of treatment results in 782 patients was conducted. There were 239 patients with gastric ulcers, 488 patients with duodenal ulcers, 37 patients with combined ulcers and 18 patients with bleeding peptic ulcers of gastroenteranastomosis. The choice of surgical policy was based on emergency fibrogastroscopy findings. According to these findings the locality and severity of bleeding were defined using J. Forrest scale. The treatment began in intensive care with obligatory endoscopic control "by the program". Emergency operations were performed in 5,9% cases and urgent operations were performed in 16.4% cases of all patients who suffered with bleeding. There were 21,7% patients with operative treatment in remote and planned order. Postoperative mortality was 3,8%. Postoperative complications were in 12,2% patients. There were consider that the treatment of ulcerative gastroduodenal bleedings should be based on the individual active and waiting policy concluding in somatic patient's condition, duration of ulcerative anamnesis, presence of gastroduodenal bleedings in the past, ulcer location, and bleeding intensity (using J. Forrest scale) and effectiveness of conservative hemostasis.
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Wong, Grace L. H., Louis H. S. Lau, Jessica Y. L. Ching, Yee-Kit Tse, Rachel H. Y. Ling, Vincent W. S. Wong, Philip W. Y. Chiu, James Y. W. Lau, and Francis K. L. Chan. "Prevention of recurrent idiopathic gastroduodenal ulcer bleeding: a double-blind, randomised trial." Gut 69, no. 4 (June 22, 2019): 652–57. http://dx.doi.org/10.1136/gutjnl-2019-318715.
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ObjectivePatients with a history of Helicobacter pylori-negative idiopathic bleeding ulcers have a considerable risk of recurrent ulcer complications. We hypothesised that a proton pump inhibitor (lansoprazole) is superior to a histamine 2 receptor antagonist (famotidine) for the prevention of recurrent ulcer bleeding in such patients.DesignIn this industry-independent, double-blind, randomised trial, we recruited patients with a history of idiopathic bleeding ulcers. After ulcer healing, we randomly assigned (1:1) patients to receive oral lansoprazole 30 mg or famotidine 40 mg daily for 24 months. The primary endpoint was recurrent upper GI bleeding within 24 months, analysed in the intention-to-treat population as determined by an independent adjudication committee.ResultsBetween 2010 and 2018, we enrolled 228 patients (114 patients in each study group). Recurrent upper GI bleeding occurred in one patient receiving lansoprazole (duodenal ulcer) and three receiving famotidine (two gastric ulcers and one duodenal ulcer). The cumulative incidence of recurrent upper GI bleeding in 24 months was 0.88% (95% CI 0.08% to 4.37%) in the lansoprazole arm and 2.63% (95% CI 0.71% to 6.91%) in the famotidine arm (p=0.313; crude HR 0.33, 95% CI 0.03 to 3.16, p=0.336). None of the patients who rebled used aspirin, non-steroidal anti-inflammatory drugs or other antithrombotic drugs.ConclusionThis 2-year, double-blind randomised trial showed that among patients with a history of H. pylori-negative idiopathic ulcer bleeding, recurrent bleeding rates were comparable between users of lansoprazole and famotidine, although a small difference in efficacy cannot be excluded.Trial registration numberNCT01180179; Results.
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Pokydko, M. I., T. V. Formanchuk, O. V. Goncharenko, A. M. Formanchuk, and V. A. Katsal. "The complex treatment of patients with perforated gastroduodenal ulcers." Reports of Vinnytsia National Medical University 22, no. 3 (September 28, 2018): 479–84. http://dx.doi.org/10.31393/reports-vnmedical-2018-22(3)-17.
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To improve the immediate results of surgical treatment of patients with perforated gastroduodenal ulcers using minimally invasive correction and an integrated treatment. The results of 253 patients with perforated gastroduodenal ulcers who were treated from 2013 to 2018 were analyzed. Chronic ulcers were found in 82 (32%) cases among all gastric ulcers, acute ones constituted 42 (16%) cases. Chronic duodenal ulcers reached 94 (37%), acute ones constituted 35 (14%). The diagnostic laparoscopy was performed in 13 (5%) patients, in 8 (3%) patients the perforated hole was sutured laparoscopically and in 5 (2%) patients the conversion was performed. Abdominocentesis with preoperative abdominal cavity drainage was carried out in 45(18%) patients. Through this drainage after exudate evacuation 200 ml of dekasan solution was injected. In 119 cultures of abdominal exudates with determinate pathogenic microflora Enterococcus faecalis dominated - 31 patients (26%). Among the postoperative complications the failure of intestinal sutures was observed in 4 (1.5%) patients. Postoperative mortality was 11.5%. Progression of multiple organ failure became the cause of mortality in 17 (59%) patients. Thus, the time from the moment of perforation till the moment of surgery must not be the sole criterion in the choice of method of operative intervention, and it is insufficient as an absolute indicator for the possibility of the radical surgical procedures (gastric resection). Undoubtedly laparoscopic suturing of the perforated gastroduodenal ulcer has advantages over laparotomy.
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Negovan, Anca, Mihaela Iancu, Valeriu Moldovan, Septimiu Voidazan, Simona Bataga, Monica Pantea, Kinga Sarkany, Cristina Tatar, Simona Mocan, and Claudia Banescu. "Clinical Risk Factors for Gastroduodenal Ulcer in Romanian Low-Dose Aspirin Consumers." Gastroenterology Research and Practice 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/7230626.
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Background. Aspirin use for cardiovascular or cancer prevention is limited due to its gastrointestinal side effects.Objective. Our prospective, observational case-control study aims to identify the predictive factors for ulcers in low-dose aspirin consumers (75–325 mg/day).Methods. The study included patients who underwent an upper digestive endoscopy and took low-dose aspirin treatment.Results. We recruited 51 patients with ulcer (ulcer group) and 108 patients with no mucosal lesions (control group). In univariate analysis, factors significantly associated with ulcers were male gender (p=0.001), anticoagulants (p=0.029), nonsteroidal anti-inflammatory drugs (p=0.013), heart failure (p=0.007), liver (p=0.011) or cerebrovascular disease (p=0.004), diabetes mellitus (p=0.043), ulcer history (p=0.044), and alcohol consumption (p=0.018), but notHelicobacter pyloriinfection (p=0.2). According to our multivariate regression analysis results, history of peptic ulcer (OR 3.07, 95% CI 1.06–8.86), cotreatment with NSAIDs (OR 8, 95% CI 2.09–30.58) or anticoagulants (OR 4.85, 95% CI 1.33–17.68), male gender (OR 5.2, 95% CI 1.77–15.34), and stroke (OR 7.27, 95% CI 1.40–37.74) remained predictors for ulcer on endoscopy.Conclusions. Concomitant use of NSAIDs or anticoagulants, comorbidities (cerebrovascular disease), and male gender are the most important independent risk factors for ulcer on endoscopy in low-dose aspirin consumers, in a population with a high prevalence ofH. pyloriinfection.
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Ishii, Yasuaki, Hiroaki Yamada, Takeshi Sato, Soichiro Sue, Hiroaki Kaneko, Kuniyasu Irie, Tomohiko Sasaki, et al. "Effects of Vonoprazan Compared with Esomeprazole on the Healing of Artificial Postendoscopic Submucosal Dissection Ulcers: A Prospective, Multicenter, Two-Arm, Randomized Controlled Trial." Gastroenterology Research and Practice 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/1615092.
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Background. Vonoprazan affords more clinical benefits than proton pump inhibitors (PPIs) during the healing of gastroduodenal ulcers. However, it remains controversial whether vonoprazan is more effective than PPIs when used to heal artificial ulcers arising after endoscopic submucosal dissection (ESD). Aim. This study investigated the effects of vonoprazan compared with esomeprazole on the healing of post-ESD artificial ulcers. Methods. Sixty patients who underwent gastric ESD between May 2015 and May 2017 were randomized to treatment with vonoprazan (V group) or esomeprazole (E group) for 8 weeks. Upper endoscopy was performed at 4 and 8 weeks after ESD, and drug effects were estimated based on the ulcer healing rates and shrinkage rates. Results. Fifty-three patients were analyzed. The respective 4- and 8-week ulcer healing rates did not differ significantly between V and E groups (8.0 versus 11.5%, P=0.669; 88.9 versus 84.6%, P=0.420). Similarly, the respective 4- and 8-week ulcer shrinkage rates did not differ significantly between V and E groups (96.8 versus 97.5%, P=0.656; 100 versus 100%, P=0.257). Conclusion. The healing of artificial ulcers after ESD did not differ using vonoprazan or esomeprazole. Both vonoprazan and esomeprazole were effective when used to promote artificial ulcer healing after ESD.
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Begovic, Goran, and Redzep Selmani. "Etiological Factors in Urgent Gastroduodenal Ulcer." PRILOZI 36, no. 2 (December 1, 2015): 203–10. http://dx.doi.org/10.1515/prilozi-2015-0068.
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Abstract Aim: The goal of the study is to assess the impact of the etiological and risk factors in the cases of urgent gastroduodenal ulcer. Methods: This is a prospective study which included 67 patients selected randomly, all with urgent, life-threatening complications of the gastroduodenal ulcer, treated at the University Clinic for Digestive Surgery and the University Clinic for Gastroenterohepatology. For the purpose of the study the titer of IgG antibodies to Helicobacter pylori in serum is examined, as well as the use of NSAID and aspirin. We also tested the use of nicotine and alcohol. Besides these factors, we took into consideration the sex and the age. Results: The serological test of Helicobacter pylori was positive in 89.6% of the cases. 31.3% used NSAID and 16.4% used aspirin. Large number, 65.7% of the patients were smokers, while 25.4% used alcohol. With regard to the sex, 83.6% were male and 16.4% were female. The most frequent age group was the one from 41 to 60 years with 40.3% and those between 61 and 80 years of age with 35.8%. Conclusion: The presence of Helicobacter pylori with the urgent gastroduodenal ulcer was exceptionally high, in 89.6% of the duodenal and gastric ulcers. NSAID and aspirin are factors that also influence the etiology of this disease. Smoking is a significant risk factor. Alcohol is less present, but still an important factor.
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Sheptulin, Arkadiy A. "Contribution of Vladimir Kharitonovich Vasilenko and his disciples to the study of ulcer disease." Clinical Medicine (Russian Journal) 95, no. 6 (July 2, 2017): 495–98. http://dx.doi.org/10.18821/0023-2149-2017-95-6-495-498.
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The article outlines the contribution of V.Kh. Vasilenko and his disciples to the study of ulcer disease including substantiation of its pathogenesis as a result of disbalance between the aggressive action of acidic and peptic factors and protective potential of gastric and duodenal mucosa based on the evaluation of their role in mucus production, epithelial cell regeneration, secretion of gastrointestinal peptides, and other processes. Special emphasis is laid on the differentiation between ulcer disease and symptomatic gastroduodenal ulcers as proposed by Vasilenko, his analysis of the clinical picture and diagnostics of ulcer disease depending on the patient’s age and sex, evaluation of therapeutic efficiency of antiulcer medicines. Recent literature data confirm Vasiolenko’s idea about different role of selected pathogenic factors in individual patients with ulcer disease.
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HERRINGTON, J. LYNWOOD. "Gastroduodenal Ulcer." Annals of Surgery 207, no. 6 (June 1988): 754–69. http://dx.doi.org/10.1097/00000658-198806000-00015.
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Tomita, Toshihiko, Sumire Mori, Katsuyuki Tozawa, Eitatsu Arai, Nobuo Tano, Hideo Oka, Yongmin Kim, et al. "Are the Symptoms of an NSAID-Induced Ulcer Truly Milder Than Those of an Ordinary Ulcer?" Gastroenterology Research and Practice 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/4653250.
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Objective. The percentage of patients with nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin- (LDA-) induced ulcers who complain of gastrointestinal symptoms has generally been considered to be low. The aim of this study was to examine and compare the symptoms and quality of life (QOL) at peptic ulcer onset. Methods. This study involved 200 patients who were confirmed by endoscopy to be in the acute stage of gastroduodenal ulcer (A1-H1). Patients completed a self-administered questionnaire (Global Overall Symptom score and SF-8) at ulcer onset, and data were compared between NSAIDs/LDA ulcers and non-NSAIDs/LDA ulcers. Results. The upper gastrointestinal symptoms score was significantly lower for patients using LDA only (20.5 ± 9.4 in the nonusing group, 19.6 ± 8.6 in the NSAIDs-only group, 16.7 ± 11.6 in the LDA-only group, and 18.5 ± 7.2 in the NSAIDs/LDA group, P<0.05). The QOL score (physical summary) was significantly lower in the NSAID group (42.1 ± 9.9) than in the nonusing group (47.6 ± 7.6) (P<0.05). Patients’ characteristics showed no significant differences among the groups, with the exception of age. Conclusion. The severity of upper abdominal symptoms at peptic ulcer onset was similar between NSAID users and nonusers.
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Sheptulin, A. A., S. S. Kardasheva, and A. A. Kurbatova. "Peptic ulcer disease: changes it has undergone over the past 50 years." Clinical Medicine (Russian Journal) 98, no. 8 (February 7, 2021): 583–87. http://dx.doi.org/10.30629/0023-2149-2020-98-8-583-587.
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This review considers the main changes in our understanding of the etiology of peptic ulcer disease (PUD), its treatment and prevention. It is emphasized that the discovery of H. pylori infection and the implementation of eradication therapy did not solve all the issues related to PUD. Further investigation is needed to study the pathogenesis of idiopathic gastroduodenal ulcers, as well as ulcerative lesions of the stomach and duodenum, caused by various medications (non-steroidal anti-inflammatory drugs in particular).
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Levenstein, Susan. "Peptic Ulcer at the End of the 20th Century: Biological and Psychological Risk Factors." Canadian Journal of Gastroenterology 13, no. 9 (1999): 753–59. http://dx.doi.org/10.1155/1999/521393.
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The prevailing concept of peptic ulcer etiology has swung over entirely in just a few years from the psychological to the infectious, yet the rich literature documenting an association between psychosocial factors and ulcer is not invalidated by the discovery ofHelicobacter pylori. Physical and psychological stressors interact to induce ulcers in animal models, concrete life difficulties and subjective distress predict the development of ulcers in prospective cohorts, shared catastrophes such as war and earthquakes lead to surges in hospitalizations for complicated ulcers, and stress or anxiety can worsen ulcer course. Many known ulcer risk factors, including smoking, nonsteroidal anti-inflammatory drug use, heavy drinking, loss of sleep and skipping breakfast, can increase under stress; the association of low socioeconomic status with ulcer is also accounted for in part by psychosocial factors. Among possible physiological mechanisms, stress may induce gastric hypersecretion, reduce acid buffering in the stomach and the duodenum, impair gastroduodenal blood flow, and affect healing or inflammation through psychoneuroimmunological mechanisms. Psychosocial factors seem to be particularly prominent among idiopathic or complicated ulcers, but they are probably operative in run of the millH pyloridisease as well, either through additive effects or by facilitating the spread of the organism across the pylorus, while gastrointestinal damage by nonsteroidal anti-inflammatory drugs can also be potentiated by stress. Although the clinical importance of peptic ulcer is fading along with the millenium, due to secular trends and new therapies, it remains worthy of study as a splendid example of the biopsychosocial model.
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Sheptulin, A. A. I., S. S. Kardasheva, and A. Beer. "Idiopathic gastro-duodenal ulcers." Clinical Medicine (Russian Journal) 96, no. 8 (December 20, 2018): 702–6. http://dx.doi.org/10.18821/0023-2149-2018-96-8-702-706.
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Idiopathic gastroduodenal ulcers (IGD) are stomach and duodenal ulcers not associated with Helicobacter pylori infection or with the administration of non-steroidal anti-inflammatory drugs. Their relative frequency ranges from 1.6 to 35%, and is likely to be overestimated due to frequent false negative test results. The etiology and pathogenesis of IGDH remain poorly understood. Factors contributing to their development can serve as old age, hereditary predisposition, disorders of gastric mucus, mesenteric ischemia. Compared to the positive peptic ulcer disease, PYLORI is characterized by less favorable course, higher frequency of gastrointestinal bleeding (including repeated), slow healing, more frequent recurrence. Treatment of IGD involves long-term use of proton pump inhibitors (PPI).
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Kolesnikov, Dmitriy Leonidovich, Vera Evgenevna Nogteva, Alina Vadimovna Lobanova, and Mihail Valentinovich Kukosh. "Risk assessment of ulcerative gastroduodenal bleeding recurrence." Journal of Experimental and Clinical Surgery 12, no. 1 (March 2, 2019): 17–22. http://dx.doi.org/10.18499/2070-478x-2019-12-1-17-22.
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Importance of the topic. Bleeding from ulcers of the gastroduodenal zone has been a very urgent problem in surgery for many years. According to a number of authors, the mortality rate is up to 30–40% with their relapse.
Aim of the study is to create a prognostic scale for assessing the risk of relapse of ulcerative gastroduodenal bleeding.
Materials and methods. The work is based on a retrospective analysis of 520 case histories of patients treated at the Berezov City Clinical Hospital No. 7, the basis of the Department of Faculty Surgery of the «Privolzhsky Research Medical University», regarding ulcerative gastroduodenal bleeding during 2010-2017. A comparative analysis of two groups of patients (depending on the occurrence or absence of relapse) is made in the SPSS-2.0 program using a logistic regression method in order to identify a combination of factors influencing the prognosis of the disease.
Results and their discussion. Such factors like the patient's age, the size of the ulcer, the use of combined endoscopic hemostasis, the intensity of bleeding at the time of an emergency EGD, the localization of the ulcer defect have a significant impact on the risk of recurrence. Basing to obtained data, we have developed a scale for assessing the risk of recurrence of ulcerative gastroduodenal bleeding.
Conclusion. The presented method allows to attribute a patient to one or another risk group and it helps to choose the optimal treatment tactics in a short period of time.
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Rácz, Istvan, Milan Szalai, Nora Dancs, Tibor Kárász, Andrea Szabó, Mihaly Csöndes, and Zoltan Horváth. "Pantoprazole before Endoscopy in Patients with Gastroduodenal Ulcer Bleeding: Does the duration of Infusion and Ulcer Location Influence the Effects?" Gastroenterology Research and Practice 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/561207.
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The aim of this study was to investigate the effect of preemptive pantoprazole infusion on early endoscopic findings in patients with acute ulcer bleeding. Records of 333 patients admitted with acute ulcer bleeding were analyzed. Ulcer bleeders were given either 80 mg bolus of pantoprazole followed by continuous infusion of 8 mg per hour or saline infusion until endoscopy. In 93 patients saline infusion whereas in 240 patients bolus plus infusion of pantoprazole was administrated with mean (±SD) durations of5.45±12.9hours and6.9±13.2hours, respectively (P=0.29). Actively bleeding ulcers were detected in 46/240 (19.2%) of cases in the pantoprazole group as compared with 23/93 (24.7%) in the saline infusion group (P=0.26). Different durations of pantoprazole infusion (0–4 hours,>4 hours, and>6 hours) had no significant effect on endoscopic and clinical outcome parameters in duodenal ulcer bleeders. Gastric ulcer bleeders on pantoprazole infusion longer than 4 and 6 hours before endoscopy had actively bleeding ulcers in 4.3% and 5% compared to the 19.5% active bleeding rate in the saline group (P=0.02andP=0.04). Preemptive infusion of high-dose pantoprazole longer than 4 hours before endoscopy decreased the ratio of active bleeding only in gastric but not in duodenal ulcer patients.
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Vladimirova, Elizaveta, Lyubov Tveritneva, Era Beresneva, Olga Alekseyechkina, Irina Popova, Galina Titova, and Irina Selina. "Diagnosis of perforation from the penetrating ulcer of the posterior wall of the duodenum." Hirurg (Surgeon), no. 5-6 (June 1, 2020): 38–52. http://dx.doi.org/10.33920/med-15-2003-02.
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The article is devoted to the problem of emergency surgery for abdominal organs – perforated ulcer of the posterior duodenal wall (duodenum). 140 patients with perforated duodenal ulcer were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine between 2016 and 2019. Eight patients had perforation from the penetrating ulcer of the posterior duodenal wall. The average age of patients with perforation from the penetrating ulcers in the posterior duodenal wall was 62.25 years (27 to 78 years). Most of the cases were found in men – 87.5%. 7 patients had surgery at the Institute, one was transferred from another medical institution where he underwent surgery. Four patients were discharged with a favorable outcome, and four died. Two of the deceased patients had perforation associated with penetrating duodenal ulcer that was diagnosed during laparotomy; in two other cases, perforation associated with the penetrating ulcer was detected only during autopsy. A feature of perforated gastroduodenal ulcers when they are localized on the posterior wall of the duodenum is poor clinical manifestation, which is associated with the entry of duodenal contents into a limited retroperitoneal space, leading to a significant inflammatory process of retroperitoneal tissue. Complex use of X-ray examination, oesophagogastroduodenoscopy, and CT allows to correctly assess and timely diagnose perforation associated with the penetrating ulcer of the posterior wall of the duodenum into the retroperitoneal space.
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Mischinger, H. J., H. Cerwenka, HJ Marsoner, W. Schweiger, G. Werkgartner, and H. Hauser. "Gastroduodenal Ulcer Bleeding." European Surgery-Acta Chirurgica Austriaca 34, no. 4 (August 2002): 220–25. http://dx.doi.org/10.1046/j.1563-2563.2002.02056.x.
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FERNANDES, Yuri Costa Farago, Gabriel da Rocha BONATTO, and Mauro Willeman BONATTO. "RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION." Arquivos de Gastroenterologia 53, no. 3 (September 2016): 152–55. http://dx.doi.org/10.1590/s0004-28032016000300006.
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ABSTRACT Background Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. Objective This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Methods Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. Results During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. Conclusion The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.
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Yamaoka, Yoshio. "Roles of the plasticity regions of Helicobacter pylori in gastroduodenal pathogenesis." Journal of Medical Microbiology 57, no. 5 (May 1, 2008): 545–53. http://dx.doi.org/10.1099/jmm.0.2008/000570-0.
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Putative virulence genes of Helicobacter pylori are generally classified into three categories: strain-specific genes, phase-variable genes and genes with variable structures/genotypes. Among these, there has recently been considerable interest in strain-specific genes found outside of the cag pathogenicity island, especially genes in the plasticity regions. Nearly half of the strain-specific genes of H. pylori are located in the plasticity regions in strains 26695 and J99. Strain HPAG1, however, seems to lack a typical plasticity region; instead it has 43 HPAG1-specific genes which are either undetectable or incompletely represented in the genomes of strains 26695 and J99. Recent studies showed that certain genes or combination of genes in this region may play important roles in the pathogenesis of H. pylori-associated gastroduodenal diseases. Most previous studies have focused on the plasticity region in strain J99 (jhp0914–jhp0961) and the jhp0947 gene and the duodenal ulcer promoting (dupA) gene are good candidate markers for gastroduodenal diseases although there are some paradoxical findings. The jhp0947 gene is reported to be associated with an increased risk of both duodenal ulcers and gastric cancers, whereas the dupA gene, which encompasses jhp0917 and jhp0918, is reported to be associated with an increased risk of duodenal ulcers and protection against gastric cancers. In addition, recent studies showed that approximately 10–30 % of clinical isolates possess a 16.3 kb type IV secretion apparatus (tfs3) in the plasticity region. Studies on the plasticity region have only just begun, and further investigation is necessary to elucidate the roles of genes in this region in gastroduodenal pathogenesis.
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Golubovic, Gradimir, Ratko Tomasevic, Biljana Radojevic, Aleksandar Pavlovic, and Predrag Dugalic. "Significance of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in patients with bleeding from upper part of the gastrointestinal tract." Vojnosanitetski pregled 64, no. 7 (2007): 445–48. http://dx.doi.org/10.2298/vsp0707445g.
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Background/Aim. Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory drugs (NSAIDs) use are considered to be the most important risk factors having influence on the onset of bleeding gastroduodenal lesions. Whether there is an interaction between H. pylori infection and the use of NSAIDs in the development of peptic ulcer disease is still controversial. The aim of the present study was to evaluate the prevalence of NSAIDs use and H. pylori infection in patients presented with bleeding gastroduodenal lesions. Methods. During the period from January 2003 - December 2003 we prospectively obtained data of all the patients (n=106) presented with signs of upper gastrointestinal bleeding. All the patients were admitted to the intensive care unit, with the endoscopy performed within 12 hours after admission. Histologic analysis was used for the detection of H. pylori infection. The NSAIDs and aspirin use data were obtained by anamnesis. Results. The results of our study revealed that the most common sources of upper gastrointestinal bleeding were duodenal (57 patients, 53.77%) and ventricular (36 patients, 33.96%) ulcers. The majority of the examined cases were associated with both H. pylori infection and NSAIDs use. A statistically significant difference among the studied groups of patients was proven. Conclusion. The majority of bleeding gastroduodenal lesions were associated with the coexistence of H. pylori infection and NSAIDs use, while their independent influences were statistically less important. Eradication of H. pylori infection in patients using NSAIDs might prevent upper gastrointestinal hemorrhage and reduce peptic ulcer bleeding risk. .
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Cherednikov, Evgeny Fedorovich, Sergey Viktorovich Barannikov, Alexander Anatolievich Anatolievich Glukhov, Igor Nikolaevich Banin, Yuri Valentinovich Mallev, and Vadim Vladimirovich Adianov. "The Use of Asepticob-A and Platelet-rich Plasma in Complex Endoscopic Teatment of Patients with Ulcer Gastroduodenal Bleeding." Vestnik of Experimental and Clinical Surgery 10, no. 2 (September 23, 2017): 116–22. http://dx.doi.org/10.18499/2070-478x-2017-10-2-116-122.
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Relevance. Gastroduodenal ulcer bleeding is one of the most complex problems of emergency abdominal surgery. An endoscopic hemostasis is a crucial importance during the treatment of patients with gastroduodenal bleeding. The using of biologically active draining sorbents in combination with local haemostatic drugs is a promising direction in the endoscopic hemostasis.Objective. The aim of the investigation is to improve the results of treatment of patients with acute ulcerative gastroduodenal hemorrhages by application of biologically active draining of sorbent Asepticob-A in combination with platelet-rich plasma for endoscopic hemostasis as an important component of complex therapy.Materials and methods. The study is based on the results of treatment of 112 patients with peptic ulcer bleeding. They were treated in the specialized city centre for the treatment of patients with gastrointestinal bleeding of Voronezh state hospital of emergency medical care №1. During the treatment of patients of the main group (n=57 persons) was used individual complex approach with the using of biologically active draining of sorbent of new generation – Asepticob-A and platelet-rich plasma in endoscopic treatment of bleeding complications of gastroduodenal ulcers. In the comparison group (n=55 persons) was used the well-known traditional methods of endoscopic hemostasis without the use of granular sorbents and platelet-rich plasma.Results and discussion. The effectiveness of treatment of patients with ulcerative gastroduodenal bleeding was assessed according to the criteria of reliability of hemostasis, assessment of dynamics of reparative processes in ulcerous defects, the frequency of recurrence of bleeding on the background of treatment using endoscopic techniques, prevention, emergency operations and mortality rate. The methods of treatment of gastroduodenal bleeding with the combined use of biologically active draining sorbents and platelet-rich plasma for the reliability of endoscopic haemostasis, that was developed and introduced into clinical practice, reduces the number of emergency operations in 2.6 times, mainly due to the reduction of recurrent bleeding and, as a consequence, leads to lower postoperative mortality.Conclusions. The use of biologically active draining of sorbent Asepticob-A and platelet-rich plasma in complex endoscopic treatment of patients with ulcerative gastroduodenal bleeding allows to reduce the frequency of recurrence of bleeding from 10.9% to 3.5% (3.1 times), to reduce the number of emergency surgical interventions at the height of bleeding from 9.1% to 3.5% (2.6 times), to reduce postoperative mortality from 5.45% to 1.75% (3.1 times) and reduce the duration of inpatient treatment from 9.0 to 6.0 days (p<0.05).
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Romantsov, Mikhail N., Eugene F. Cherednikov, Aleksandr Anatolevich Glukhov, and Constantine O. Fursov. "New technologies of endoscopic hemostasis in a treatment protocol of patients with gastroduodenal ulcer bleeding." Vestnik of Experimental and Clinical Surgery 11, no. 1 (April 8, 2018): 16–23. http://dx.doi.org/10.18499/2070-478x-2018-11-1-16-23.
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Relevance of research. Acute gastroduodenal bleeding is remaining a difficult and largely unsolved problem up to day. The fundamental importance in treating this category of patients is an endoscopic hemostasis. The decisive point in this problem is the most stable hemostasis and preventing a recurrence of a hemorrhage. In this regard, the search of new solutions and the development of known methods of treatment of the gastroduodenal ulcer bleeding is an important issue.
Aim of research. To evaluate the effectiveness of the treatment protocol of patients with the gastroduodenal ulcer bleeding by applying combined endoscopic insufflations of hemostatic agents and a diovin as an integral part of a complex therapy.
Materials and methods. The research is based on results of treatment of the patients with the gastroduodenal ulcer bleeding being in a medical setting at the departments of surgery at Voronezh city clinical emergency hospital №1. During the treatment of the main group (59 patients) there was used an integrated approach with the usage of powdered hemostatic agents of gelplastan and lyophilisate NovoSeven in combination with diovin in the endoscopic treatment of gastroduodenal ulcer bleeding. There were used the traditional well-known methods of the endoscopic hemostasis without the usage of hemostatic agents and absorbent grains in treatment of the control group (56 patients).
Results and discussion. The evaluation of results of patients’ treatment with gastroduodenal ulcer bleeding was performed according to the figures of the final hemostasis, the frequency of recurrent bleeding, the prevention of emergency operations, the rates of mortality, the duration of hospitalization. The developed protocol of the patients’ treatment with gastroduodenal ulcer bleeding with the usage of combined the endoscopic insufflation of two hemostatics and diovin makes it possible to achieve the maximum persistent hemostasis at 94.9% of patients, to reduce the risk of recurrent hemorrhages by 2.5 times, to prevent emergency operations and, as a result, to reduce the lethality.
Conclusion. The usage of new technologies of endoscopic hemostasis by the hemostatic pneumoinsufflation gelplastan and lyophilisate NovoSeven in combination with diovin in the treatment of patients with gastroduodenal ulcer bleeding allows to reduce the risk of recurrent hemorrhage from 12,5% to 5,01% (by 2,5 times), to prevent emergency operations, to reduce the lethality from 3,65% to 1,7% (by 2,1 times) and to reduce the period of staying in the hospital from 10,2 to 7,4 bed days (p<0.05).
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T., Kemparaj, and Ashika Bagur. "Presence of Helicobacter pylori infection in gastroduodenal perforations." International Surgery Journal 7, no. 6 (May 26, 2020): 1908. http://dx.doi.org/10.18203/2349-2902.isj20202405.
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Background: Gastroduodenal perforations constitute one of the commonest surgical emergencies encountered. Helicobacter pylori is a gram negative bacterium that has infected more than half the world’s population. The most commonly recognized manifestation of H. pylori infection in India is peptic ulcer disease. Although the relationship between H. pylori infection and peptic ulcer has been well defined, the relationship of H. pylori infection with gastroduodenal perforation is still controversial. The objective of the study was to determine the presence of H. pylori in gastroduodenal perforations.Methods: We conducted a prospective study, noting the number of cases which turned out to be positive for H. pylori in cases of gastroduodenal perforations intraoperatively, using rapid urease test.Results: Out of 100 cases of gastroduodenal perforations operated, 74% were positive for the test. Gastric perforations positive for the test were 81.4% and duodenal perforations positive for the test were 68.42%.Conclusions: There is a positive attribution between H. pylori infection and gastroduodenal perforations.
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Zherlov, G. K. "Modern trends in diagnostics and treatment of gastroduodenal ulcers." Bulletin of Siberian Medicine 2, no. 4 (December 30, 2003): 5–14. http://dx.doi.org/10.20538/1682-0363-2003-4-5-14.
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In the lecture the modern views on diagnistics and tactic choice in the treatment of complicated and uncomplicated gastroduodenal ulcers have been presented and long-term results of organ-saving and organ-modeling surgery experience during complicated stomach and duodenal ulcers have been analyzed. Achievements in life quality saving of operated patients have been cited. Novel classifications of gastroduodenal anastomosis functional activity and anastomositis degrees have been proposed.
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Costa, Francisco Assis Uma, Silvaria Maria Medeiros de Sousa Silva, and Ana Maria Quessada. "ULCERA GASTRODUODENAL EM CÃES." Ciência Rural 23, no. 3 (December 1993): 383–84. http://dx.doi.org/10.1590/s0103-84781993000300026.
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As ulcerações no sistema digestivo de cães são consideradas raras. São descritos dois casos de úlcera gastroduodenal em cães. O primeiro animal apresentou úlcera no duodeno próxima!. O segundo mostrou úlcera perfurada na região pilórica do estômago. Nenhum dos animais apresentou evidências de sangramento, mas as lesões eram profundas e arredondadas. Não houve evidência de patologias concorrentes.
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ERASMUS, J. F. P. "GASTRODUODENAL ULCERS AND NEOPLASMS." Acta Medica Scandinavica 152, S306 (April 24, 2009): 26–38. http://dx.doi.org/10.1111/j.0954-6820.1955.tb16279.x.
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Musinov, I. M., A. E. Chikin, A. S. Ganin, and E. Yu Kachesov. "Transcatheter arterial embolization in the treatment of gastrointestinal ulcer bleeding." VESTNIK KHIRURGII IMENI I.I.GREKOVA 177, no. 6 (December 30, 2018): 27–30. http://dx.doi.org/10.24884/0042-4625-2018-177-6-27-30.
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The objective was to study the efficacy of transcatheter arterial embolization of gastric and duodenal vessels and to determine the indications for its use in gastroduodenal ulcer bleeding.Material and methods. The study was based on the results of arterial embolization in 61 patients with gastroduodenal ulcer bleeding.Results. Transcatheter arterial embolization of the left gastric artery, its branches and the gastroduodenal artery with an adhesive glue composite based on N-butyl-2-cyanoacrylate is highly effective in arresting bleeding permanently and preventing its relapse.Conclusion. Transcatheter arterial embolization is an alternative to the surgical treatment in patients with gastrointestinal bleeding.
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Ektov, Vladimir Nikolaevich, Oleg Evgenevich Minakov, Vladimir Aleksandrovich Muzalkov, Anna Viktorovna Kuzina, Natalya Vladimirovna Chernyshova, Vitalii Konstantinovich Donchenko, and Stanislav Gennadevich Brezhnev. "Evaluation of the dynamics of the main indicators of treatment care and the long-term results of conservative treatment of ulcerative gastroduodenal bleeding." Vestnik of Experimental and Clinical Surgery 11, no. 3 (September 28, 2018): 167–72. http://dx.doi.org/10.18499/2070-478x-2018-11-3-167-172.
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Relevance. Improvement of medical and diagnostic care for ulcerous gastroduodenal bleeding is a complex problem of modern medicine, the solution of which is connected both with the search for and introduction of modern medical technologies into clinical practice, and with the necessity to conduct in-depth analysis of the effectiveness of medical care in this pathology at various stages of its delivery.
Purpose .To study the dynamics of the main indicators of the provision of medical and diagnostic care to patients with ulcerative gastroduodenal bleeding in a large multidisciplinary hospital and to evaluate the long-term results of conservative treatment of this group of patients.
Materials and methods. An assessment of the dynamics of the main indicators of the provision of medical and diagnostic care for ulcerative gastrointestinal bleeding in the Voronezh Regional Clinical Hospital for the period from 1989 to 2010, during which 1831 patients were hospitalized. Long-term results of 106 patients were analyzed. Among the patients, males predominated (70.7%), the average age was 50.2 ± 4.7 years (median - 18 - 79 years). In 62 patients (58.5%) bleeding ulcer was located in the duodenum.
Results. During the analyzed period there was a general tendency to reduce the number of hospitalizations by 57.8%. Surgical activity in this pathology in 1989-1993 was 56.0%; in the period from 2009 to 2013, this indicator decreased to 33.8% against the background of an increase in the postoperative mortality to 8.7%. In the evaluation of long-term results, favorable outcomes of treatment were noted - in 74.5% of patients. In 17.9% of patients with peptic ulcer with predominant localization of ulcers in the DPC, the development of various complications and recurrences of bleeding was noted, which gives grounds for recommending in the current situation the implementation of planned surgical interventions.
Conclusions. Conservative treatment of ulcerative gastroduodenal bleedings with the use of endoscopic technologies creates conditions for optimization of immediate and long-term outcomes of treatment. The polyethiologic nature of the disease and the significant specific gravity of severe combined pathology makes it urgent to introduce a multidisciplinary brigade principle for the treatment of ulcerative gastroduodenal bleeding.
Key words: ulcerative gastroduodenal bleeding.
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Krstic, S. N., T. Alempijevic, M. N. Krstic, Z. D. Lausevic, A. Sijacki, V. R. Djukic, D. Jovanovic, B. Stefanovic, and V. Arsenijevic. "Surgical treatment of gastroduodenal ulcer bleeding: Our experience." Acta chirurgica Iugoslavica 54, no. 1 (2007): 165–67. http://dx.doi.org/10.2298/aci0701165k.
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Introduction: Acute bleeding from the upper gastrointestinal tract remains the commonest emergency in gastroenterology, and is most often caused by gastroduodenal ulcer disease. Despite introduction of novel endoscopic techniques and pharmacological treatment, 6-15% patients have to be operated. The aim of our investigation is analyze data of patients treated for gastrointestinal ulcer bleeding in our institution, their treatment options and outcome. Patients and methods: We included 2237 patients admitted in the Department for Emergency medicine of Clinical center of Serbia during the period from January 1999 until December 2003. because of gastroduodenal ulcer bleeding. We analyzed age, gender treatment option, hospital stay and mortality. Results: The mean age of our patients was 61.58 years, 1346 male and 891 female. The majority of patients were conservatively treated (84.5%). Operated patients mostly undergo Billroth II resection (57.8%). The mean hospital stay was 7.3 days. Average mortality was 14.4% Conclusions: Despite adequate endoscopic management of bleeding gastroduodenal ulcer, surgeons will continue to treat this patients for emergency surgery.
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Garg, Malika, James A. Strauchen, Richard R. P. Warner, and Celia M. Divino. "Radioembolization-Induced Gastroduodenal Ulcer." American Surgeon 78, no. 5 (May 2012): 621–23. http://dx.doi.org/10.1177/000313481207800550.
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Melmer, Patrick D., Trenton Banks, Sharon Holmes, Jason D. Sciarretta, and John Mihran Davis. "Gastroduodenal Surgery: A Persistent and Continuing Challenge." American Surgeon 84, no. 7 (July 2018): 1204–6. http://dx.doi.org/10.1177/000313481808400739.
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The number of patients being treated surgically for gastroduodenal disease has decreased over the past five decades as a result of focus on medical treatment. However, perforated and bleeding peptic ulcer disease (PUD) continues to represent a significant percentage of patients who require emergency surgery. The aim of this study was to characterize these critically ill surgical patients treated for gastroduodenal disease in our hospital. A retrospective, single-center, consecutive cohort study of all patients identified from the hospital National Surgical Quality Improvement Program database who were admitted to our institution requiring emergent surgical intervention over the past two years was conducted. Of 423 patients, 33 (7.8%) had operative procedures for complications of PUD, of which 19 patients (57.6%) had perforation; nine patients (27.3%) had hemorrhage; one patient (3.0%) had both perforation and hemorrhage; two patients (6.1%) had distal gastrectomies for ulcers refractory to medical management alone, and two patients (6.1%) had gastrectomies for malignant gastric neoplasms. There is a significant population of patients who present with life-threatening complications of PUD, despite the decline in PUD worldwide. These patients are critically ill and require careful and diligent management for good outcomes.
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Bezdekova, Barbora, P. Jahn, and M. Vyskocil. "Pathomorphological study on gastroduodenal ulceration in horses: Localisation of lesions." Acta Veterinaria Hungarica 55, no. 2 (June 1, 2007): 241–49. http://dx.doi.org/10.1556/avet.55.2007.2.10.
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Gastroduodenal ulceration is a prevalent disease in foals and adult horses. Decreased performance as well as fatal complications relate to this syndrome. The objective of our study was to determine the prevalence of gastric ulceration in a mixed population of horses by postmortem examination and to evaluate a possible association between equine gastric ulcer syndrome (EGUS) and sex or age of the examined horses, to evaluate the localisation of lesions in the proximal part of the gastrointestinal tract and to determine the occurrence of gastric parasites. Post-mortem examinations were performed on 71 horses over a period of 24 months. Gastric ulcers were found in 52 horses (73.2%). There was no significant association between age or sex and occurrence of gastric ulcers. In all horses the squamous mucosa lesions were localised near the margo plicatus (100% of the cases), whereas in 23 horses the lesions were near the margo plicatus and lesser curvature and in 7 horses at the greater curvature. In 18 horses the mucosa was affected in the whole extent of the margo plicatus and in 1 horse diffuse lesions of the squamous mucosa were noted. Lesions of the glandular mucosa were localised in 11 horses at the fundic area, in 1 horse they occurred in the pylorus, and in 10 horses diffuse lesions of the glandular mucosa were recorded. A low prevalence of Gasterophilus intestinalis infection was detected (1 horse, 1.4%). We have confirmed that gastric ulcers are a common problem in horses and duodenal or oesophageal ulceration is rare (not a single case of the latter was found in this study). Lesions in the glandular mucosa of the stomach are more frequent in suckling foals than in older animals. Lesions of the glandular mucosa are also common in adult horses, and a complete gastroscopic examination including examination of the pylorus is advisable to evaluate this syndrome.
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Shepetko, E. N., and P. D. Fomin. "CLASSIFICATION OF OPERATIONS FOR COMPLICATED GASTRODUODENAL ULCERS." Kharkiv Surgical School, no. 3-4 (December 20, 2019): 101–4. http://dx.doi.org/10.37699/2308-7005.3-4.2019.22.
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Abstract. A unified classification of operations for complicated gastroduodenal ulcers has been proposed to understand their place in the structure of surgical interventions, technological features and methods for their implementation, as well as functional efficacy and prevention of recurrent ulceration. This is a classification of operations in the pyloroduodenal zone with complicated duodenal ulcers, classification of vagotomy, classification of gastroenterostomy and classification of gastric resection. The proposed of operations classification for complicated gastroduodenal ulcers will help to a wide range of surgeons not only in understanding the range of surgical interventions, but also in an effort to master the techniques of operations for their application in surgical practice.
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Allahverdiyev, Vidadi Agababa. "THE EFFICACY OF RECOMBINANT INTERLEUKIN-1Β IN SURGICAL TREATMENT OF ACUTE ULCERATIVE GASTRODUODENAL BLEEDINGS." Russian Clinical Laboratory Diagnostics 64, no. 11 (November 15, 2019): 669. http://dx.doi.org/10.18821/0869-2084-2019-64-11-669-669.
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There was reported the results of the use of recombinant interleukin-1β in basic conservative measures in the surgical treatment of acute gastroduodenal ulcer bleeding. Gastric ulcer were in 20 patients, duodenal ulcer in 84 patients and combined ulcers in 16 patients. According to А.А. Шалимов hospitalized patients with mild blood loss were 27, moderate degree - 62 and severe degree - 31 patients. According to J. Forrest, 29 showed active bleeding (F Ia, F Ib), in 67 - unstable hemostasis (F IIa, F IIb, F IIc) and in 24 - F III. Within the framework of differentiated individual-active tactics, patients were operated in emergency (21), urgent (38), delayed (35), and 26 people underwent early planned operations. Patients in the main group (63) after the operation, was included recombinant interleukin-1β to the basic therapeutic measures additionally, taking into account the degree of blood loss and immune disorders. Patients of comparison group (57) before and after surgery received standard basic therapy without immunocorrection. In a comparative aspect, it has been proved that in postoperative period on the background of standard conservative measures, the use of recombinant interleukin-1β positively influences elimination of the secondary immunodeficiency and cytokine imbalance significantly improves the results of surgical treatment.
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Moroz, E. V., A. Y. Karateev, E. V. Kryukov, A. A. Sokolov, and E. N. Artemkin. "Comparison of the Endoscopic Picture in Case of Complications of the upper Gastrointestinal Tract Caused by the Use of Antithrombotic Agents and Non-Steroidal Anti-Inflammatory Drugs." Acta Biomedica Scientifica 4, no. 5 (November 14, 2019): 19–25. http://dx.doi.org/10.29413/abs.2019-4.5.3.
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Intaking antithrombotic funds (ATA) and non-steroidal anti-inflammatory drugs (NSAIDs) is one of the most frequent causes of pathology in gastrointestinal (GI) tract.The purpose of the study: comparison of pathological changes of the mucous membrane in the upper GI tract, that occur against the background of ATA and NSAIDs admission.Material and methods. Endoscopic data of two groups of patients taking ATA and NSAIDS have been compared. The first group of 448 patients from the 10th Gastrointestinal Department in N.N. Burdenko Main Military Clinical Hospital was on record from 2013 to 2017. The patients had erosive ulcerous changes of gastrointestinal mucosa, occurred against the background of the ATA admission. The second group comprised 6431 patients with rheumatic diseases. They were hospitalized in the clinic of V.A. Nasonova Research Institute of Rheumatology in the period from 2007 to 2016 and took NSAIDs regularly.Results. Duodenal and gastric ulcer changes in gastric mucosa and duodenal ulcers were identified in 168 (37.5 %) patients taking ATA and in 1691 (26.3 %) patient treated with NSAIDS. Structure of pathology varied. So, against the background of ATA and NSAIDS admission, the number of acute gastric ulceration amounted to 6.5 % and 15.5 % (p < 0.001); acute ulcers duodenal was 2.9 % and 4.9 %; combined ulcerative lesions of gastric and duodenal was 2.9 % and 2.0 %; multiple erosions of gastroduodenal mucosa were 52.4 % and 15.7 % (p < 0.001); single erosion was 35. 1% and 61.6 %. The factor of ulcer history and age ≥ 65 years old increased significantly the risk of duodenal and gastric ulcer changes in patients taking ATA and NSAIDs: OR 5.182 (95% CI 2.701–9.942) and 3.24 (95% CI 2.19–5.34), 4.537 (95% CI 2.036–10.11) and 2.016 (95% CI 1.230–2.917) respectively. Intaking of proton pump inhibitor (PPI) reduced significantly the risk of complications for both ATA and NSAIDs: OR 0.329 (95% CI 0.199–0.546) and 0.317 (95% CI 0.210–0.428) respectively.Conclusion. The structure of pathology of mucous in the upper gastrointestinal tract that arose against the backdrop of ATA and NSAIDs admission is different. The first is characterized by a multiple erosion, while the second one has single acute distal gastric ulcers. The ulcerative history and advanced age of patients increase significantly the risk of complications concerning the gastroduodenal mucosa when using ATA and NSAIDs. PPI is the effective means of preventing this pathology.
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Valentini, M., R. Cannizzaro, M. Poletti, R. Bortolussi, A. Fracasso, V. Testa, M. Sozzi, M. Fornasarig, F. Bortoluzzi, and I. Grazioli. "Nonsteroidal antiinflammatory drugs for cancer pain: comparison between misoprostol and ranitidine in prevention of upper gastrointestinal damage." Journal of Clinical Oncology 13, no. 10 (October 1995): 2637–42. http://dx.doi.org/10.1200/jco.1995.13.10.2637.
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PURPOSE The prophylactic strategy of nonsteroidal antiinflammatory drug (NSAID)-induced upper gastrointestinal (UGI) damage has largely been studied in arthritic patients, but not in cancer patients. The efficacy of misoprostol and ranitidine in the prevention of gastroduodenal damage in patients taking diclofenac for their cancer pain has been compared in this study. PATIENTS AND METHODS Patients who needed high-dose (200 to 300 mg/d) diclofenac for cancer pain and without mucosal lesions at baseline gastroduodenal endoscopy were randomized to receive misoprostol (200 micrograms twice daily; M group) or ranitidine (150 mg twice daily; R group). UGI endoscopy was repeated after 4 weeks. RESULTS Twenty-three patients treated with misoprostol and 26 treated with ranitidine concluded the study. The M group showed a significantly (P < .02) lower incidence of gastroduodenal lesions (two patients; 8.7%) than the R group (10 patients; 38.5%). Gastric ulcers occurred in one (4%) misoprostol-treated patient and in six (23%) ranitidine-treated patients. Six of seven patients with ulcers were asymptomatic. Seventy-one percent and 86% of ulcers occurred in patients older than 60 years and in those who received greater than 3.1 mg/kg of diclofenac, respectively. CONCLUSION Misoprostol was significantly more effective than ranitidine in the prevention of gastroduodenal lesions in cancer patients receiving diclofenac.
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Agrawal, Naurang M. "Misoprostol in the Treatment and Prevention of Nonsteroidal Anti-Inflammatory Drug-Induced Gastrointestinal Mucosal Injury." Canadian Journal of Gastroenterology 4, no. 3 (1990): 120–25. http://dx.doi.org/10.1155/1990/416532.
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Three studies are discussed with regard to the efficacy of misoprostol, a synthetic prostaglandin Et analogue, in the treatment and prevention of NSAID-induced gastroduodenal lesions in patients with rheumatoid arthritis and osteoarthritis. ln the treatment study, misoprostol was found to be highly effective in healing aspirin-induced gastroduodenal lesions, eg, intramucosal hemorrhage, erosions, and gastric and duodenal ulcers, in patients with rheumatoid arthritis continuing NSAID therapy. Treatment successes were reported in 60% ( week 4) and 70% ( week 8) of patients receiving misoprostol compared with 31% (week 4) and 25% (week 8) of patients receiving placebo (P=0.0001). Furthermore, misoprostol did not adversely affect anti-inflammatory and analgesic efficacy of aspirin in rheumatoid arthritis. ln one prevention study, misoprostol co-administered with therapeutic doses of NSAIDs, was found co be safe and effective in preventing NSAID-induced gastric ulcers in osteoarthritic patients. At week 12, 94% of patients on 100 μg misoprostol qid were ulcer-free versus 99% on 200 μg misoprostol qid and 78% on placebo (P<0.001 ). In a second prevention study the preliminary analysis of data showed the superior efficacy of misoprostol compared to sucralfate in preventing NSAID-induced gastric ulcers. New findings from research on prostaglandin analogues suggest that they may have therapeutic applications beyond the prevention and treatment of NSAID-induced gastrointestinal mucosal damage. Misoprostol may protect against-NSAID induced renal dysfunction, may reduce the damage to cartilage that has been associated with some NSAIDs, and is associated with a reduction in the incidence of rejection crises as well as with improvement in renal function in patients undergoing renal transplantation.
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Klyuev, I. I., V. M. Surin, I. N. Piksin, and V. S. Belikov. "Vagotomy in surgery of gastroduodenal ulcers." Kazan medical journal 66, no. 2 (April 15, 1985): 113–15. http://dx.doi.org/10.17816/kazmj60903.
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Żyluk, Andrzej, Samir Zeair, Janusz Kordowski, and Ewa Gabrysz-Trybek. "Persisting bleeding from the duodenal ulcer in patients with occlusion of the celiac trunk: a case report." Polish Journal of Surgery 93, no. 1 (October 23, 2020): 1–5. http://dx.doi.org/10.5604/01.3001.0014.8072.
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Introduction: Endoscopic measures have continued to be the primary procedures in the management of ulcer bleeding. Nevertheless, in cases of failed endoscopic hemostasis and re-bleedings, endovascular techniques have gradually gained increased acceptance as an alternative to surgery, allowing to avoid surgical intervention in some cases. Case report: A case of a 42-year-old patient presenting to the authors’ institution with massive bleeding from the duodenal ulcer, sprang from a pathologically enlarged gastroduodenal artery is reported. This vascular anomaly was a consequence of occlusion of the coeliac trunk (Dunbar syndrome), which was shown on an angio-CT scan. In spite of several endoscopic and endovascular measures, as well as three operations, the bleeding persistently recurred (a total of 6 episodes) and the patient eventually died. The article presents details of operative and endovascular treatments. Contemporary trends in management in cases of failed endoscopic interventions and re-bleedings form peptic ulcers are shown in the discussion.
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Żyluk, Andrzej, Samir Zeair, and Ewa Gabrysz-Trybek. "Persisting bleeding from the duodenal ulcer in patients with occlusion of the celiac trunk: a case report." Otolaryngologia Polska 75, no. 2 (October 23, 2020): 1–5. http://dx.doi.org/10.5604/01.3001.0014.7395.
Full textAbstract:
Introduction: Endoscopic measures have continued to be the primary procedures in the management of ulcer bleeding. Nevertheless, in cases of failed endoscopic hemostasis and re-bleedings, endovascular techniques have gradually gained increased acceptance as an alternative to surgery, allowing to avoid surgical intervention in some cases. Case report: A case of a 42-year-old patient presenting to the authors’ institution with massive bleeding from the duodenal ulcer, sprang from a pathologically enlarged gastroduodenal artery is reported. This vascular anomaly was a consequence of occlusion of the coeliac trunk (Dunbar syndrome), which was shown on an angio-CT scan. In spite of several endoscopic and endovascular measures, as well as three operations, the bleeding persistently recurred (a total of 6 episodes) and the patient eventually died. The article presents details of operative and endovascular treatments. Contemporary trends in management in cases of failed endoscopic interventions and re-bleedings form peptic ulcers are shown in the discussion.
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Mishra, Swastik, Pankaj Kumar, Prakash Kumar Sasmal, and Tushar Subhadarshan Mishra. "Iatrogenic injury of duodenum: malady of a therapeutic misadventure." BMJ Case Reports 14, no. 4 (April 2021): e242294. http://dx.doi.org/10.1136/bcr-2021-242294.
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Endoscopic procedures are the front-runner of the management of bleeding duodenal ulcer. Rarely, surgical intervention is sought for acute bleeding, not amenable to endoscopic procedures. Oversewing of the gastroduodenal artery at ulcer crater by transduodenal approach is the most acceptable and recommended method of treatment. We describe a case of an intraoperative duodenal injury that occurred during an attempt to oversew the gastroduodenal artery after a duodenotomy, leading to an unsatisfactory and meagre duodenal stump. This case will highlight the intraoperative turmoil, postoperative complications and management of a series of anticipated but unfortunate events that have rendered us wiser in terms of surgical management of a bleeding duodenal ulcer.
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Smolovic, Brigita, Dejana Stanisavljevic, Mileta Golubovic, Ljiljana Vuckovic, Biljana Milicic, and Srdjan Djuranovic. "Bleeding gastroduodenal ulcers in patients without Helicobacter pylori infection and without exposure to non-steroidal anti-inflammatory drugs." Vojnosanitetski pregled 71, no. 2 (2014): 183–90. http://dx.doi.org/10.2298/vsp1402183s.
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Background/Aim. A high risk of bleeding in Helicobacter pylori (H.pylori)-negative, non-steroidal anti-inflammatory drugs (NSAID)-negative ulcers highlights the clinical importance of analysis of the changing trends of peptic ulcer disease. The aim of the study was to investigate the risk factors for ulcer bleeding in patients with non-H. pylori infection, and with no NSAIDs use. Methods. A prospective study included patients with endoscopically diagnosed ulcer disease. The patients were without H. pylori infection (verified by pathohistology and serology) and without exposure to NSAIDs and proton pump inhibitors (PPI) within 4 weeks before endoscopy. After endoscopy the patients were divided into 2 groups: the study group of 48 patients with bleeding ulcer and the control group of 47 patients with ulcer, but with no bleeding. Prior to endoscopy they had completed a questionnaire about demographics, risk factors and habits. The platelet function, von Willebrand factor (vWF) and blood groups were determined. Histopathological analysis of biopsy samples were performed with a modified Sydney system. The influence of bile reflux was analyzed by Bile reflux index (BRI). Results. Age, gender, tobacco and alcohol use did not affect the bleeding rate. The risk of bleeding did not depend on concomitant diseases (p = 0.509) and exposure to stress (p = 0.944). Aspirin was used by 16/48 (33.3%) patients with bleeding ulcer, as opposed to 7/47 (14.9%) patients who did not bleed (p = 0.036). Abnormal platelet function had 12/48 (25.0%) patients who bled, as opposed to 2/47 (4.3%) patients who did not bleed (p = 0.004). Patients with BRI < 14 bled in 79.2%, and did not bleed in 57.4% of the cases (p = 0.023). There was no statistical difference between groups in regards to blood groups and range of vWF. Antrum atrophy was found in 14/48 (29.2%) patients with bleeding ulcer and in only 5/47 (10.6%) patients who had ulcer without bleeding (p = 0.024). Conclusion. Abnormal platelet function, aspirin use and antrum atrophy were the risk factors for ulcer bleeding in non-H. pylori, non- NSAIDs ulcer disease.
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Tulassay, Z., J. Papp, and G. Lengyel. "Seasonal periodicity in gastroduodenal ulcers." Gastrointestinal Endoscopy 34, no. 3 (May 1988): 287–88. http://dx.doi.org/10.1016/s0016-5107(88)71343-7.
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Loffroy, Romaric, Boris Guiu, Jean-Pierre Cercueil, Côme Lepage, Marianne Latournerie, Patrick Hillon, Patrick Rat, Frédéric Ricolfi, and Denis Krausé. "Refractory Bleeding From Gastroduodenal Ulcers." Journal of Clinical Gastroenterology 42, no. 4 (April 2008): 361–67. http://dx.doi.org/10.1097/mcg.0b013e3180319177.
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van Lanschot, J. J. B., M. van Leerdam, O. M. van Delden, and P. Fockens. "Management of Bleeding Gastroduodenal Ulcers." Digestive Surgery 19, no. 2 (2002): 99–104. http://dx.doi.org/10.1159/000052019.
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