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

PGE2-like immunoactivity was measured radioimmunologically in specimens from gastric corpus mucosa in (a) healthy subjects, (b) patients without liver disease in the absence or presence of gastric ulcer, and (c) patients with alcoholic cirrhosis in the absence or presence of gastric ulcer, further divided into subgroups without or with portal hypertension. The PGE2-like immunoactivity was almost the same in subjects without liver disease and in cirrhotic patients without portal hypertension. A significantly decreased PGE2-like immunoactivity was found in patients with portal hypertension, especially in cases of congestion in the mucosa. A further decrease of the PGE2-like immunoactivity could be found whenever gastric corpus ulcer was present. This decrease is statistically significant. We therefore concluded that a decrease in the PGE2-like immunoactivity in the gastric mucosa of cirrhotic patients is closely related to portal hypertension. Congestion in the mucosa, thought to be a relevant factor in the pathogenesis of the mucosal PGE2 deficiency, might also play a role.
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PMID:Decreased prostaglandin E2 immunoactivity of gastric mucosa in portal hypertension. 203 Aug 9

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 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

Upper gastrointestinal hemorrhage is one of the more important complications of cirrhosis. Most of the available data regarding the prevalence of upper and lower gastrointestinal sites of bleeding in cirrhotic patients have been obtained in individuals with alcoholic cirrhosis evaluated in the course of an acute gastrointestinal bleeding episode. Few data exist, however, as to the prevalence of either potential bleeding sites or of normal endoscopic findings in hemodynamically stable individuals with cirrhosis of any etiology. Five hundred ten cirrhotic subjects, who were evaluated for possible liver transplantation (OLTx) between January 1985 and June 1987, were included in this study. Seventy-five had alcoholic cirrhosis and 435 had nonalcoholic cirrhosis of various etiologies. Of these 510 patients, 412 underwent combined upper and lower gastrointestinal endoscopy and 98 underwent upper gastrointestinal endoscopy alone. Gastritis, gastric and duodenal ulcer disease were found significantly (each at least p less than 0.025) more often in patients with alcoholic liver disease than in those with nonalcoholic liver disease. The prevalence of the various lower gastrointestinal lesions in both groups was similar. Of particular interest is the fact that in alcoholic cirrhotics, the prevalence of gastritis, gastric ulcer and duodenal ulcer disease was unrelated to the degree of portal hypertension, whereas in the nonalcoholic cirrhotics the prevalence of gastritis and duodenal ulcer disease but not gastric ulcer disease was associated significantly with the degree of portal hypertension as assessed by the presence or absence of large esophageal varices, ascites, and hepatic encephalopathy.
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PMID:Combined upper and lower gastrointestinal endoscopy: a prospective study in alcoholic and nonalcoholic cirrhosis. 269 Jun 64

A 57-year-old woman with rheumatoid arthritis and alpha 1-antitrypsin deficiency (PiMZ phenotype), recovering from intraabdominal sepsis in association with gastric ulcer perforation, had portal hypertension. An operative liver biopsy specimen showed a distinctive elastosis of the portal tracts without cirrhosis.
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PMID:Hepatic changes in a patient with alpha 1-antitrypsin deficiency (MZ phenotype). Portal tract elastosis and noncirrhotic portal hypertension. 660 30

Eighty-eight patients with bleeding esophageal varices due to portal hypertension underwent splenectomy and devascularization of the upper half of the stomach and the abdominal esophagus. A Hegar dilator no. 17 was introduced into the esophagus through a gastrotomy. A ring of separated stitches was applied at cardia level, the needle being inserted as far as the metallic surface so as to include the entire wall of the esophagus. Complete interruption of all gastroesophageal vascular communication was thus obtained. After suture of the gastrotomy, a Nissen or Lind's fundoplication was performed. In 62 (70.45%) patients, the immediate postoperative course was uneventful, 21 had non-lethal complications, 13 had abdominal evisceration, six pulmonary complications, four subphrenic abscesses, five patients died, two in hepatic coma, two after reoperation for subphrenic abscess and one after massive hemorrhage due to an acute gastric ulcer. Forty-three patients (48.8%) developed transient ascites which disappeared before they were discharged from the hospital. In thirteen patients (15.6%), the hemorrhage recurred. Of the 32 patients operated one to two years ago, only one rebled. Of the 35 patients operated three to five years ago, nine rebled and three, of the 16 patients operated from five to seven years ago, rebled. With radiological and endoscopic investigations, reduced varices were seen above the suture line, in many cases, passively filled up with blood returning from the azygos vein. Reflux esophagitis was observed in 17 patients who had had a Lortat-Jacob procedure to reduce the His angle; of these, eight rebled later. No gastroesophageal reflux was seen after Nissen or Lind's fundoplication. No fistulae, dysphagia or stenosis was observed.
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PMID:A new procedure for the treatment of bleeding esophageal varices by transgastric azygo-portal disconnection. 660 5

Endoscopic evaluation of 100 consecutive cases of haematemesis and melaena attending the emergency ward of NRS Medical College, Calcutta 700014 showed that in 2/3rd of all the patients acid peptic disease was the cause of bleeding, out of which 60% was due to duodenal ulcer and 40% was due to gastric ulcer. Five per cent of all the cases were having portal hypertension where the cause of bleeding was oesophageal varices. Gastric malignancy was responsible for bleeding in 3% cases. In about 6% cases bleeding was due to acute gastric erosion caused by NSAID, steroid and other corrosive agents. In 20% patients no apparent cause for upper gastro-intestinal haemorrhage could be detected endoscopically.
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PMID:Clinical and endoscopic evaluation of gastroduodenal haemorrhage. 796 1

A case of spontaneous bacterial peritonitis (SBP) developed in an old man whose ascitic fluid was related neither to portal hypertension nor nephrotic syndrome, but with severe hypoalbuminemia emerged after a massive bleeding from a gastric ulcer in a malnutrition state. Ascitic fluid, increasing day by day, yielded Enterobacter cloacae and Bacteroides fragilis. Though autopsy was not carried out because of refusal of his family, neither liver necropsy, nor abdominal CT scan nor repeated abdominal ultrasonography showed findings suggesting existence of liver cirrhosis. In the presence of his ascites, the extent of a chemiluminescence (CL) response of polymorphonuclear cells from volunteers was significantly lower than that of his serum. This report shows that SBP can develop in a patient with ascites unrelated to portal hypertension when ascitic fluid induces little CL response.
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PMID:[A case of spontaneous bacterial peritonitis with ascites caused by hypoproteinemia after a massive bleeding from a gastric ulcer]. 845 Feb 77

Iatrogenic arteriovenous fistula of the superior mesenteric vessels is rare, with only 22 cases being documented. We report herein a case of a 63-year-old man with an iatrogenic arteriovenous fistula which developed after a small bowel resection for intestinal tuberculosis. The patient was admitted to our hospital for a gastric ulcer, at which time an ultrasonogram demonstrated cystic dilatation of the superior mesenteric vein, proving to be an arteriovenous fistula of the mesenteric vessels. An angiogram of the superior mesenteric vessels subsequently confirmed this diagnosis and resection of the fistula was performed, followed by an uneventful recovery. Iatrogenic mesenteric arteriovenous fistula with no presenting symptoms, as in our case, is uncommon and surgery performed before the development of associated portal hypertension should achieve good results. A review of the literature follows the report of this case.
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PMID:Superior mesenteric arteriovenous fistula: report of a case and review of the literature. 846 9


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