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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A description of malignant carcinoid of alveolartrabecular structure developing in the edge of chronic progressive gastric ulcer is presented. Granules detectable by argirophilic method of Grimelius, toluidine blue after acid hydrolysis, and lead hemotoxylin were found in the cytoplasm of tumor cells. Changes in the epithelium of the type of cancer in situ as well as marked hyperplasia of argirophilic cells were observed in gastric mucosa in the edges of the ulcer. Although this observation may be interpreted as a peculiar variant of Zollinger-Ellison syndrome, it is more likely that this is a malignized chronic ulcer with carcinoid differentiation of the tumor tissue.
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PMID:[Malignant carcinoid that developed against a background of chronic gastric ulcer]. 68 6

Among 81 patients with malignancies of the stomach, the early (cancer of the gastric mucosa) was diagnosed in 10 (12.3%) patients. Timely diagnosis of the early gastric cancer requires multiple endoscopic examinations and aimed gastric biopsies of the edges and bottom of the ulcer. The analysis of the serial histological preparations permits to detect single or small aggregations of large mucous cells looking like cricoid cells (considered by the author as a sign of malignization) and less frequently like tumour tissue, in necrotic mass or in the proper layer of the mucous membrane. It is recommended that any gastric ulcer be considered as a possible ulcerative form of cancer and that the patients be mandatorily examined in specialized institutions where the differential diagnosis between peptic ulcer and ulcerative form of cancer may be performed by the method of gastroscopy with aimed biopsy.
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PMID:[Histological evaluation of aimed gastrobiopsy in the diagnosis of early stomach cancer]. 72 63

It has been postulated that resection therapy for peptic ulcer disease will result in an increased frequency of gastric stump cancer depending on the ulcer type and type of operation (Billroth I, Billroth II, gastroenterostomy). However, an extensive review of the literature shows that after Billroth II resection for gastric ulcer without enteroanastomosis the frequency of primary gastric stump cancer is not greater than in the case of medically treated benign gastric ulcers. The frequency of cancer of the gastric stump seems lower after resection for duodenal ulcer disease. It is possible that the combination of the Billroth II resection with an enteroanastomosis decreases the frequency of cancer of the gastric remnant. Clinical and experimental studies do not allow final statements on cancer frequency after Billroth I resection or simple gastroenterostomy.
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PMID:[What is certain in the pathogenesis and incidence of primary carcinoma involving the operated stomach?]. 76 96

This case-control study of Hawaiian Japanese indicated that gastric ulcer in the proximal portion of the pyloric antrum has features similar to those of gastric cancer. Such ulcers occurred at sites most frequently and most severely affected by intestinal metaplasia, although metaplasia tended to be more extensive with cancer than with ulcer. Metaplastic mucosa was more vulnerable to the action of pepsin and acid than was normal mucosa. The risk of ulceration would rise when a sufficiently lagrge area of the antrum was intestinalized and when the corpus continued to produce significant quantities of these substances. This study showed a strong association between salt intake, ulcer, and metaplasia. Significant but less dramatic associations were demonstrated between metaplasia and the use of traditional Japanese foods and smoking. The question was raised as to whether salt promotes ulceration or whether it potentiates the action of a mutagen that causes intestinal metaplasia.
J Natl Cancer Inst 1977 Jan
PMID:Epidemiologic pathology of gastric ulcer and gastric carcinoma among Japanese in Hawaii. 83 57

This is a report on 64 patients, who were operated on because of gastric ulcer situated near the cardia. We found the best results after the so-called step-like resection, which is preferable to selective vagotomy with excision of the ulcer and pyloroplasty because of the special conditions of the secretion of gastric juice in the case of high ulcers. Because of the danger of the development of a cancer in a B-II-stomach we prefer the B-I-anastomosis. For ulcers with stenosis of the esophagus a cardiofundectomy should be performed. Ulcers high on the greater curvature and in the fundus should be excised and a distal gastrectomy (B-I) should follow. The sole excision of the ulcer or the operation according to Kelling-Madlener are not recommended.
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PMID:[The treatment to the high gastric ulcer (author's transl)]. 86 2

Despite the initial healing achieved by medical treatment with carbenoxolone, surgery is frequently needed in the management of gastric ulcer. We have studied 150 patients over the past 10 years in an attempt to define the place of conservative surgery compared with the standard partial gastrectomy of the Billroth I type. Functional results have not been significantly different and the individual surgeon's choice will depend on his philosophy with regard to the risk of cancer in the postoperative stomach, and his technical expertise with the newer kinds of vagotomy. To my mind it is perfectly justifiable to use highly selective vagotomy with excision of the ulcer to treat gastric ulcer alone, especially if the patient is one in whom postgastrectomy symptoms could be disabling. Further follow-up is needed to decide whether it should replace partial gastrectomy as the standard procedure.
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PMID:Surgery for gastric ulcer. 86 56

During the study period 1972-74 gastric ulcer was demonstrated by endoscopy in 114 patients, 54 of whom were included in the present study. Forty-two were excluded because of ulcer showing incipient healing, superficial erosions, manifest or suspected malignancy, or indication for surgery. Eighteen patients were not included because of advanced age, complicating diseases, or refusal to have further examinations. The study comprises a treatment phase and a follow-up phase. The treatment phase ran from the first encoscopic demonstration of gastric ulcer until complete healing. During this period the patient was treated with antacids and anticholinergics and, if required by his condition, admission to hospital. During the treatment phase, endoscopy was performed at intervals of from 3 to 6 weeks until healing. During the follow-up phase endoscopy was carried out in the event of dyspeptic complaints that might indicate recurrent ulcer. The healing and recurrence rates for various periods were calculated by the aid of the life-table method. After 1 mo. of treatment 13% of the aptients exhibited healing, after 2 mo. 29%, after 3 mo. 41%, and after 12 mo. 79%. In one month 9% of the primarily healed ulcers had recurred, in 2 mo. 15%, in 3 mo. 22%, and in 12 mo. 43%. The healing rate is appreciably lower than results reported in the literature, whereas the recurrence rate is in closer accordance with previous studies.
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PMID:Prognosis of medically treated gastric ulcer. A prospective endoscopic study. 88 34

Recognising the inhibitory activity of acetazolamide upon acid gastric secretion and its favorable effects in the treatment of gastric ulcer which we have described (see reference) - we applied the therapeutical testing by acetazolamide in the differentiation of benign from malignant niches of the stomach. Acetazolamide was administered orally at doses of 25-30 mg per kilogram body weight in a long term trial, together with 3 gr sodium bicarbonate, 1 gr potassium bicarbonate, 1.5 gr magnesium oxide per day and an increased quantity of liquids, to 741 patients with radiologically demonstrated ulcer craters. The fundamental criterion was the size of the niche as established by radiologic examination. In all gastric ulcers the size of the niche was considerably reduced after 7-9 days of treatment with acetazolamide; the niche disappeared in 2-3 weeks. This favorable result was obtained without diet and rest. In 38 cases in which there was no significant radiologic change of the niche after 7-9 days of treatment with acetazolamide - the malignancy of the niche was confirmed. The simplicity and the effectiveness of this rapid therapeutic test, makes it useful in the differentiation of benign from a malignant ulcer craters.
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PMID:Therapeutic testing by acetazolamide in the differentiation of a benign from a malignant niche. 88 70

Three cases of gastrocolic fistula due to benign gastric ulcer seen during a 5-year period are presented. Although colonic or gastric malignancy is said to be the commonest cause of gastrocolic fistula, in the same period only 1 case due to colonic carcinoma was seen. The important role played by radiology in the diagnosis of gastrocolic fistula is emphasized and the clinical presentation is discussed, together with the possible role of analgesics in the aetiology.
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PMID:Benign gastric ulcer as a cause of gastrocolic fistula. A report of 3 cases. 88 35

An analysis has been made of 235 deaths that occurred among 1905 patients with peptic ulcer who constituted a random sample of the occurrence of ulcer disease in an area of Denmark comprising half a million inhabitants. The disease itself, according to the death certificate, was considered the primary cause of death in 10% of the cases; half of these had been operated on immediately before death. The other patients died more frequently than expected from the following causes: chronic bronchitis, pulmonary emphysema, cancer of the lung, cirrhosis of the liver, and cancer of the pancreas. Although the comorbidity with chronic bronchitis and emphysema was especially pronounced in patients with gastric ulcer, the association with liver cirrhosis and cancer of the pancreas occurred only in patients with duodenal ulcer. In women the mortality rate attributable to cardiac and vascular diseases was lower than expected. No excess coincidence of suicide was found. Berkson's fallacy is considered to be of much less importance as a possible explanation of the comorbidity found in the present study than in the majority of publications concerned with this question.
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PMID:Causes of death in duodenal and gastric ulcer. 90 79


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