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)

To clarify the influence of Transcatheter Arterial Embolization (TAE) on the stomach, endoscopic examination was carried out before and after TAE. Forty-six TAE were performed in 27 patients with primary hepatoma. New gastric lesions, erosions and ulcers, were developed in 25 of 46 TAE. There was no significant relationship between the incidence of the lesions in the cases with esophageal varices (15/24) and the cases without (10/22) and there was no significant relationship between the incidence of the lesions after the first TAE (12/22) and after the second TAE (5/14). Period between the first and the second TAE had no statistical influence on the lesions after the second TAE. Hepatic functions (Child's classification; Rmax, K, R15 of ICG; serum total protein; serum albumin; total bilirubin; prothrombin time; hepaplastin test) before TAE were not statistically related to the appearance of the gastric lesions following TAE (Table 1). On the other hand, the cases which showed apparent effects of TAE including 0.2 time decrease of AFP had the more gastric lesions (P less than 0.05) (Table 2). The cases with upper abdominal pain after TAE had more gastric lesions (24/38) than the cases without (2/8) (P less than 0.05). But the cases undergone TAE with high possibility of the influx of gelatin sponge pieces, lipiodol or anticancer agents into the supplying vessels for the stomach did not exhibit significant incidence of the lesions (Table 3). Thus, when TAE is followed by a 0.2 time decrease in AFP, it is necessary to pay more attention to the gastric lesions. The prophylactic administration of H2 antagonist before or just after TAE did not seem useful to prevent the gastric lesions. These findings suggest that the influx of gelatin sponge pieces, lipiodol or anticancer agents to the stomach does not always cause gastric ulcer or erosion.
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PMID:[Factors of gastric lesions following after transcatheter arterial embolization for primary hepatoma]. 169 2

The paper presents the results of a retrospective study and the experiences with 4000 fibreoptic oesophago-gastro-duodenoscopies (EGD), which were performed at Kilimanjaro Christian Medical Centre (KCMC) between 1985 and 1989 in an open access service. Seventy per cent of all patients examined had abnormal findings with duodenal ulcer as the most frequent diagnosis (22%). Pyloric stenosis was seen in 6%, gastric ulcer in 5% and esophageal varices in 4% of all patients. High figures were found for carcinoma of the esophagus (4%) and malignancy of the stomach (5%). Gastritis was diagnosed in 11%. We consider fibreoptic EGD a cost effective and appropriate technology. Because of its high diagnostic yield, we advocate its use in certain centres in developing countries.
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PMID:Value of fibreoptic oesophago-gastro-duodenoscopy: experience with 4000 procedures at Kilimanjaro Christian Medical Centre, Moshi, Tanzania. 174 37

Among 457 Japanese cirrhotic patients with esophageal varices, 28 (6%) bled from the upper gastrointestinal tract after the initial session of endoscopic injection sclerotherapy (EIS); 13 bled during the course of repeated EIS and 15 bled mainly from gastric lesions after eradication of the varices. Of these 28 patients, bleeding from gastritis occurred in 13 (46%), from esophageal varices in 10 (36%), from gastric varices in 4 (14%) and from gastric ulcer in one (4%). Six of 13 patients with gastritis-related bleeding and 3 of 4 patients with gastric variceal bleeding died of uncontrollable hemorrhage complicated liver failure, while 9 of 10 patients with esophageal variceal bleeding were controlled and reinjection was feasible. Ten (36%) of the 28 patients, with Child's grade B or C and severe ascites, died, mainly following bleeding from gastric lesions. This study shows that bleeding from gastric lesions after EIS can be uncontrollable and fatal in patients with poor liver function.
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PMID:Gastric bleeding after endoscopic injection sclerotherapy for esophageal varices may be fatal. 177 18

Thirty-five consecutive patients undergoing endoscopic injection sclerotherapy for esophageal varices were randomly allocated to either ranitidine-administered group (18 patients) or ranitidine-nonadministered group (17 patients), in an attempt to evaluate the efficacy of ranitidine for prevention and healing of postinjection ulcer with a prospective randomized trial. Two of seventeen patients in the nonadministered group dropped out of this trial because of development of gastric ulcer, so 18 patients in the first group were evaluated and compared with the 15 remaining patients in the second group. Sclerotherapy was performed with 5% ethanolamine oleate and 0.6% polydocanol; the mean number of injection courses and the mean amount of sclerosant were the same in both groups. Moreover, there was no significant difference between the two groups in either the occurrence rate or the size of injection ulcer 1 wk after the last session. However, the persistence rate of ulcer 1 month after last injection in the ranitidine-administered group was significantly lower than that in the ranitidine-nonadministered group (6.3% vs. 38.5%, p less than 0.05). Our study demonstrated that ranitidine administration will help to hasten healing of postinjection ulcer, although it was not effective for prevention of injection ulcer.
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PMID:Prospective randomized study on the effect of ranitidine against injection ulcer after endoscopic injection sclerotherapy for esophageal varices. 201 51

Acute upper gastrointestinal bleeding (UGIB) continues to be a common cause of hospital admission and morbidity and mortality. This study reviews 469 patients admitted to a surgical service of an urban hospital. There were 562 total admissions because 53 patients were readmitted 93 times (recurrence rate, 20%). The most common causes of bleeding, all endoscopically diagnosed, included acute gastric mucosal lesion (AGML) (135 patients, 24%), esophageal varices (EV) (121 patients, 22%), gastric ulcer (108 patients, 19%), duodenal ulcer (78 patients, 14%), Mallory-Weiss tear (61 patients, 11%), and esophagitis (15 patients, 3%). Nonoperative therapy was sufficient in 504 cases (89.5%). Endoscopic treatment was used in 144 cases. Operations were performed in 58 cases (10.5%), including 29% of ulcers. Emergency operations to control hemorrhage were required in only 2.5% of all cases. The rate of major surgical complications was 11% and the mortality rate was 5.2%. There were 58 deaths (12.6%), with 36 deaths directly attributable to UGIB. Factors correlating with death include shock at admission (systolic blood pressure less than 80), transfusion requirement of more than five units, and presence of EV (all p less than 0.001). Most cases of UGIB can be treated without operation, including endoscopic treatment, when diagnostic endoscopy establishes the source. Subsequent operation in selected patients can be done with low morbidity and mortality rates.
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PMID:Upper GI bleeding in an urban hospital. Etiology, recurrence, and prognosis. 222 17

Upper gastrointestinal hemorrhage is one of the more important complications of cirrhosis and a major cause of death in such patients. The main sites of bleeding are esophageal varices, gastritis, and peptic ulcers. In order to determine the prevalence of either potential bleeding lesions or of other endoscopic findings in hemodynamically stable individuals with various etiologies of cirrhosis, 510 consecutive cirrhotic patients, evaluated for possible orthotopic liver transplantation (OLTx) underwent an upper gastrointestinal endoscopy for combined diagnostic and therapeutic purposes. The patients were divided into two main groups: 319 patients with parenchymal liver disease and 191 patients with cholestatic liver disease. Gastritis was found significantly more often in patients with parenchymal liver disease than in those with cholestatic liver disease (49.8% vs 30.9%; P less than 0.001). In contrast, the prevalence of esophagitis, esophageal and gastric varices, gastric ulcer, duodenal ulcer, and duodenitis was similar in both groups. Normal endoscopic findings were present in 5.0% of the parenchymal group and 11.5% of the cholestatic group (P less than 0.02). Ascites and encephalopathy were found significantly more often in subjects with parenchymal liver disease as compared to those with cholestatic liver disease. Portal hypertension and its degree, as assessed by the presence and size of esophageal varices, was similar in both groups, and in both groups there was a statistically significant qualitative trend of increasing prevalence of esophageal varices with increasing severity of disease as estimated using Pugh-Child's criteria.
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PMID:Prevalence of endoscopic findings in 510 consecutive individuals with cirrhosis evaluated prospectively. 234 4

The purpose of this paper is to study the use of upper gastrointestinal (Gl) fiberoptic endoscopy in children. Two hundred consecutive patients referred to one of the authors were reviewed. The indications for performing upper gastrointestinal endoscopy in these 200 patients were: (1) recurrent abdominal pain (46.5%), (2) persistent vomiting (14.5%), (3) haematemesis (14.5%), (4) acute abdominal pain (13%) and (5) other indications such as foreign body removal, failure to thrive and unexplained chest pain (11.5%). The endoscopy was performed with the Olympus P3 or Olympus XP-10 gastroscopes. The sedation used was a combination of intravenous pethidine (2mg/kg) and diazepam (0.5 mg/kg). Among the patients with recurrent abdominal pain, upper Gl endoscopy showed duodenal ulcer in 7 patients (7.5%), duodenitis in 4 (4.3%), oesophagitis in 4 (4.3%) and gastric ulcer in 2 (2.2%). The rest of the patients were normal (81.7%). With regard to persistent vomiting, 37.9% of the patients showed gastroesophageal reflux and 6.9% had a hiatus hernia. Of 29 patients examined endoscopically for upper Gl bleeding, no focus of bleeding was identified in 27.6%. The remaining 72.4% were bleeding from acute gastric erosion (27.6%), oesophagitis (17.2%), oesophageal varices (13.8%), duodenal ulcer (10.3%) and Mallory-Weiss tear (3.5%). The Majority of the patients with acute abdominal pain were normal endoscopically (61.5%). The two common abnormal findings were acute gastritis (27.0%) and acute duodenitis (11.5%). No major complications were encountered during the procedure in these 200 patients. It was concluded that upper Gl endoscopy is useful for defining upper Gl mucosal pathology. The procedure can be performed safely in children under sedation.
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PMID:Upper gastrointestinal endoscopy in children. 237 74

We analyzed the endoscopic findings in 788 patients with esophageal and gastric varices who underwent upper gastrointestinal endoscopy between 1 January 1979 and 31 December 1988. Of these, 154 patients (19.6%) had gastric varices associated in various patterns with esophageal varices. Congestive gastropathy, occurring with esophageal and gastric varices (43.4%), was the most frequent pathology detected in our patients. Esophagitis was present in 15.8% of patients, but did not correlate with variceal bleeding. Endoscopy performed at 1 day to 1 week post-hemorrhage in 313 patients accurately identified the source of bleeding in only 57.2% of patients. This figure increased to 98.2% when we performed the examination within the first 24 h of hemorrhage. In this group varices were the source of hemorrhage in 72.3% of patients while the hemorrhage came from other sources, such as erosive gastritis, duodenal and gastric ulcer in 27.6% of patients.
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PMID:Endoscopic approach to patients with portal hypertension: a complex diagnosis. A retrospective study based on 10 years' experience. 237 85

The results of injection sclerotherapy for oesophageal varices which recurred after portal non-decompressive surgery were analysed retrospectively to evaluate its efficacy. We treated 60 consecutive patients with portal hypertension; 19 were treated on an emergency basis, seven electively and 34 on a prophylactic basis. All acute bleeding was controlled with one session of sclerotherapy using a transparent overtube. After eradication by sclerotherapy, no bleeding episodes occurred and there was no recurrence of the varices, except in three uncompliant patients, during a mean follow-up period of 33.1 months. Bleeding from a gastric ulcer and gastritis occurred in one patient each. Oesophageal stenosis occurred in nine (15 per cent) patients and gastric varices developed in two (3 per cent) patients. Twelve patients died, five from liver failure and six with hepatoma, but there was no bleeding from the gastrointestinal tract. The overall 4-year survival rate was 80 per cent. We recommend the use of sclerotherapy as the primary treatment for recurrent oesophageal varices.
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PMID:Eradication of oesophageal varices recurring after portal non-decompressive surgery by injection sclerotherapy. 239 24

Intraarterial infusion therapy combining dibutyryl adenosine 3',5'-monophosphate and mitomycin C was administered to 8 patients with hepatocellular carcinoma occluding the main portal vein. Three patients survived more than nine months, including 1 who has been well for forty-eight months with technical imaging showing complete regression. A decreased level of serum alpha-fetoprotein of more than 90% was obtained in 38% of patients. Causes of death included hepatic failure, rupture of esophageal varices, acute gastric ulcer, and cerebral hemorrhage. It is concluded that the combination therapy may be useful for HCC.
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PMID:Arterial infusion of combination therapy using dibutyryl adenosine 3',5'-monophosphate and mitomycin C for hepatocellular carcinoma occluding main portal vein: case studies. 255 51


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