Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a series of 500 patients admitted to hospital for upper digestive hemorrhage, the authors studied the influence of taking drugs on the clinical characteristics and course of the original disease. Taking aspirin is exceptional before rupture of esophageal varices. One may isolate a homogenous group of elderly women consuming aspirin and another anti-inflammatory drug, and bleeding from a gastric ulcer. One may also isolate another group of men, bleeding from acute gastro-duodenal lesions after taking aspirin alone. If one considers apart portal hypertension, owing to its extreme gravity, one may note that the prognosis depends on the age. One patient out of five, dies of hemorrhage after the age of 60 years. Taking an anti-inflammatory drug at this age is thus not harmless.
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PMID:[Clinical aspects and course of drug-induced upper digestive hemorrhage]. 18 80

This report is of the results of management in a haematemesis and melaena unit at Prince Henry's Hospital, Melbourne. The unit was established in October, 1972, in response to unpublished data for the decades 1950 to 1959 and 1960 to 1969, which showed a mortality of about 15%. In the 39 months to December, 1975, 513 patients were received into a semi-intensive care setting. The unit staff consisted of a group of four surgeons and four physicians working a weekly roster. Primary care and liaison were the responsibility of the gastroenterology registrar. The basic diagnostic measure taken was the routine early use of fibreoptic duodenoscopy. The unit was set up with an agreed policy of management of the common causes of haematemesis and melaena, and data were prospectively recorded in a form suitable for computer analysis in every case. Of the 513 admissions, 378 were of males and 135 were of females. Forty-five patients died, giving an overall admission mortality of 8-8. There were 143 admissions for bleeding duodenal ulceration, 102 for acute peptic ulceration, 47 for chronic gastriculceration, 43 for oesophageal varices, 33 for Mallory-Weiss syndrome and 45 for less common causes of upper gastrintestinal bleeding. In 100 cases the source of bleeding was not discovered. Of the 143 patients admitted for chronic duodenal ulcer, either patients died, giving a mortality of 5-6%; 72 patients underwent operation, with an operative mortality of 9-7%. Of the 47 admitted with bleeding gastric ulcer, nine died (19-1%), while 26 came to operation; the operative mortality was 26-9%. There were 102 admissions for acute peptic ulceration, with an overall mortality of 11-7% (12 patients); 16 patients came to operation, with an operative mortality of 43-7%. Eleven deaths occurred in the 43 patients admitted for bleeding oesophageal varices (25-6%), with 10 patients coming to operation; the operative mortality was 30-0%. An age of greater than 50 years and shock on admission were the most significant factors for poor prognosis in this group of patients.
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PMID:The experience of a haematemesis and melaena unit: a review of the first 513 consecutive admissions. 30 Aug 34

In 277 consecutive episodes of suspected upper gastrointestinal bleeding, lesions bearing stigmata of recent haemorrhage (stigmata) were found by endoscopy in 110 (47%) out of 233 patients who were judged to have bled; 78 (33%) had lesions without stigmata, and in 45 (19%) no lesion was seen. Results in 176 entirely unselected admissions for upper gastrointestinal bleeding were similar.Forty-eight chronic duodenal and 41 chronic gastric ulcers were identified by endoscopy. Stigmata were found in 27 (56%) and 33 (80%) of these cases respectively. Sixteen patients had multiple lesions, and in 12 (75%) the presence of stigmata permitted diagnosis of the source of the haemorrhage. Stigmata were more likely to be seen in cases of duodenal ulcer, Mallory-Weiss lesions, and oesophageal varices when endoscopy was performed within 12 hours of bleeding, but were as common in cases of gastric ulcer after longer intervals.In the absence of stigmata one out of 21 patients with duodenal ulcer had further haemorrhage and one other needed emergency surgery; no patient with gastric ulcer had further haemorrhage or needed emergency surgery. In contrast, when stigmata were present 15 of the 27 patients with duodenal ulcer (56%) had further haemorrhage and 17 (63%) needed emergency surgery; of the 33 patients with gastric ulcer, 10 (30%) had further haemorrhage and 15 (45%) required emergency surgery. Superficial mucosal lesions may have been the source of haemorrhage when an ulcer unmarked by stigmata was seen at endoscopy. Stigmata were superior to any other single factor or combination of factors in predicting rebleeding and the need for emergency surgery.
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PMID:Stigmata of recent haemorrhage in diagnosis and prognosis of upper gastrointestinal bleeding. 30 6

From 388 patients with upper G.I. bleeding investigated by endoscopy, radiology or emergent surgery, one third bled from duodenal ulcer, one third oesophageal varices, and from the remain the most frequent were gastric ulcer (14%) and gastric cancer (9%). From a sample of 53 patients with liver cirrhosis, 66% bled from varices and 34% from other lesions. The proportion of patients who bled from oesophageal varices is higher under 60 yrs. The mortality was higher after 60 yrs, except when there was associated chronic liver disease or renal or cardio-respiratory failure. In this group of patients, near half in our series, the mortality is the same under and above 60 years.
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PMID:Endoscopy in the upper G.I. bleedings. 31 42

Fiberoptic endoscopy of the upper gastrointestinal tract was performed on 53 patients without incident, ranging in age between two months and 18 years, of whom 35 were out patients at the time of examination. Of 27 patients with recurrent abdominal pain and normal upper gastrointestinal series, eight had abnormal findings at endoscopy: a duodenal ulcer in four, a gastric ulcer in two and duodenitis in two. Of 18 patients with hematemesis and/or melena, esophageal varices were demonstrated both by endoscopy and x-ray in two, gastric ulcer by endoscopy in three and x-ray in one, duodenal ulcer by endoscopy in three and by x-ray in two, esophagitis by endoscopy only in one patient, erosive gastritis by endoscopy in five and by x-ray in two and duodenitis by endoscopy in three and by x-ray in two. Of the remaining eight patients with abnormal x-rays findings and other symptomatology, endoscopy demonstrated foreign bodies in two (coins, esophagus and stomach), duodenitis in two, a gastric ulcer in one, a duodenal ulcer in one and normal examination in two. The data indicate that fiberoptic endoscopy significantly improves diagnostic accuracy in the evaluation of disorders of the upper gastrointestinal tract in children and is a safe and effective procedure in ambulatory pediatric patients.
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PMID:Fiberoptic endoscopy of the gastrointestinal tract in infants and children. I. Upper endoscopy in 53 children. 60 92

Acute radiological investigation of the oesophagus, stomach and duodenum is a routine in patients admitted to the first surgical department of Kommunehospitalet, Copenhagen, with upper gastro-intestinal tract hemorrhage. In the period 1969-1972, 294 patients were admitted with hematemesis and/or melena. The acute radiological study was undertaken in 190 of these patients (65%). Whenever possible, confirmation of the acute primary radiological diagnosis was sought at acute operation, subsequent elective operation, by repeated radiological study, by gastroscopy, or at post mortem. 19 acute investigations were inadequate, and in a further 20 patients no studies subsequent to the acute study were made. There remain 151 patients, and the primary diagnosis could be confirmed in 111 (74%). 45 patients underwent acute operation, and primary diagnosis was confirmed in 66%. The most frequent primary diagnosis was duodenal ulcer (78 of 151 patients), which was verified in 63 instances (81%). In 8% of these patients subsequent definitive diagnosis of gastric ulcer was made, and in 11% no cause of bleeding could be demonstrated. Primary diagnosis of gastric ulcer in 28 patients could be confirmed in 85%. Primary diagnosis of oesophageal varices was made in 9 patients and confirmed in 7 (78%). One patient had a carcinoma of the stomach, and this was also the acute radiological diagnosis. In one patient primary diagnosis of oesophageal ulcer was made, but this could not be confirmed. In 34 patients the acute study failed to point the cause of bleeding, and in 50% of these patients subsequent examination was also non-productive. 26% subsequently evidenced duodenal ulcer; 11% gastric ulcer; 6% carcinoma of the stomach; 3% oesophageal varices; and 3%--one patient--a bleeding vessel in the fundus of the stomach. The acute radiological study was complication free. The place of the study in acute diagnosis of the patient with upper gastro-intestinal tract bleeding is discussed.
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PMID:Acute radiological investigation of oesophagus and stomach in the event of massive upper gastro-intestinal tract bleeding. 108 11

One hundred consecutive cases of upper gastrointestinal hemorrhage were studied clinically, radiologically and endoscopically. Erosive gastritis, duodenal and gastric ulcer, and bleeding esophageal varices accounted for 85% of the cases. The presenting sign of hematamesis or melena was of no value in localizing the bleeding site relative to the pyloric sphincter. Erosive lesions of the esophagus and stomach were suspected clinically in less than 50% of the cases and were the lesions least amenable to radiologic diagnosis and where early endoscopy was most useful. Our observations demonstrate again the frequent association between ethanol or aspirin ingestion and erosive gastritis.
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PMID:Upper gastrointestinal hemorrhage clinical, radiological and endoscopic correlation of 100 consecutive cases. 108 1

From November 1, 1990 to January 31, 1991, 381 patients visited our emergency unit with the chief complaints of hematemesis (n = 153) and melena (n = 228). Of these patients, 298 (78.2%) received UGI endoscopy at the emergency unit, 29 (7.6%) received examination after they were admitted to wards, 3 (0.8%) received endoscopy at outpatient clinic and 51 (13.4%) did not have endoscopy. The percentages of endoscopic diagnoses in 330 patients who had UGI endoscopy were gastric ulcer (GU) 33.6%, duodenal ulcer (DU) 32.7%, esophageal varices (EV) 17.0%, and others 15.5%. Negative findings were noted in 3 cases and no definite bleeding source was found in 1 patient who had blood retention in stomach. The diagnostic rate of endoscopy was 98.8%. Of the 56 patients with EV, 45 (80.4%) had hematemesis; in contrast, 85 of the 108 DU patients (78.8%) complained of melena only. Of the 219 patients with bleeding GU/DU, 64 (29.2%) had endoscopic therapies and 7 (3.2%) needed operation. Sixty-four (29.2%) of them received UGI endoscopy within 6 hours after arrival. They had significantly higher frequency of stigmata of recent hemorrhage (SRH) and more endoscopic therapies than the remaining patients. The overall mortality rate in our patients was 6.0%; the mortality rate in patients with EV was much higher than that of the patients with GU/DU (19.6% vs. 1.8%, P less than 0.001). Of the 23 expired cases, only 11 died of hypovolemic shock. The remaining 12 patients died of deterioration or complications of their underlying diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Endoscopy for upper gastrointestinal bleeding at emergency unit. 131 44

One hundred and sixty two patients with upper and intermediate gastrointestinal hemorrhage studied under a prospective protocol are reported. Upper endoscopy revealed lesions of the upper gastrointestinal tract in 137 patients (89%); a barium swallow performed to 92 of them failed to confirm the endoscopic diagnosis in 66 (71.7%). In 99m Tc scan suggested ectopic gastric mucosa in 9 cases; Meckel's diverticulum was confirmed by laparotomy in 7 and gastrointestinal duplication in two of them. Selective mesenteric arteriography demonstrated bleeding ileo-cecal varices in one patient. The main causes of gastrointestinal hemorrhage in the current series were duodenal ulcer (22.8%), esophageal varices (14.8%), stress ulcers (14.2%), reflux esophagitis (7.4%), aspirin-induced gastritis (6.8%), gastric ulcer (5.6%) and ectopic gastric mucosa (5.6%). These diagnosis were characteristically distributed according to pediatric age-groups. The source of bleeding could be detected in 90% of the patients studied. A clinical approach to differential diagnosis of patients with gastrointestinal bleeding is presented.
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PMID:[Usefulness of endoscopy in the differential diagnosis of hemorrhage of the upper digestive tract in children]. 146 73

The long-acting somatostatin analogue octreotide is a synthetic cyclic peptide consisting of 8 amino acids. Depending on the organ, it acts either as a hormone or as a neurotransmitter. The effect on various physiological functions in the brain and the gastrointestinal tract is mainly inhibitory. Due to its inhibitory actions, the possibility of intravenous and subcutaneous administration and the lack of serious side-effects, octreotide offers a broad spectrum of possible indications. Today octreotide is recommended in acromegaly patients and for the treatment of hormone dependent symptoms in patients with gastroenteropancreatic tumours. New indications are enterocutaneous and pancreatic fistulas and the prevention of complications in major pancreatic surgery. In patients with dumping and short-bowel syndrome, octreotide may be helpful until dietary regimens are established. In Aids patients with severe diarrhea, octreotide can be used to stabilize patients with severe dehydration and malnutrition. The clinical effectiveness on upper GI-bleeding due to gastric ulcer and oesophageal varices is still controversial. Future studies must prove whether octreotide may be helpful in treating diabetic retino- and nephropathy because of the possibility of suppressing growth hormone and IGF-I. The antiproliferative effect of octreotide also allows its use in patients with somatostatin-receptor-positive, non-endocrine solid tumors (e.g. brain, breast and small-cell lung cancer). A promising area is the scintigraphic visualization of somatostatin-receptor-positive tumors with a radio-labelled octreotide analogue and the possible target irradiation of these tumors by beta-particle emitting isotopes attached to such analogues.
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PMID:[Somatostatin analog (octreotide) in clinical use: current and potential indications]. 162 Oct 78


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