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

A 10-year experience with 2,441 patients over 65 years of age undergoing operations for non-upper gastrointestinal tracts was reviewed to evaluate both the incidence of postoperative upper gastrointestinal bleeding and the clinical risk factors associated with the complication. A total of 18 (0.7%, 7 males and 11 females) patients had overt postoperative upper gastrointestinal bleeding of non-variceal origin documented by endoscopic findings or blood transfusions. Of these, the complication developed in 10 (1.5%) of 646 patients after an operation for biliary or pancreatic disease, 1 (1.5%) of 64 for aneurysmal or obstructive arterial disease, 5 (1.1%) of 43 for colorectal cancer and 2 (0.3%) of 916 for hernia. The incidences of bleeding after an operation for obstructive jaundice (3.8%), for biliary or pancreatic malignancy (4.5%), and of unavoidable diversion colostomy for colorectal anastomosis (3.1%) were significantly higher than for non-jaundice (0.6%), for non-malignancy (1.1%) and of postoperative upper gastrointestinal bleeding in the present study. The origins of bleeding were gastric ulcer in 11, acute gastric mucosal lesion in 4, duodenal ulcer in 1 and other in 2. All cases of bleeding were treated and met success in hemostasis using H2-blockers. Of these, however, 5 patients died of multiple organ failure despite discontinued hemorrhage, prophylactic use of H2-blockers showed a decrease in occurrence of postoperative upper gastrointestinal bleeding in the present study.
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PMID:[Post operative upper gastrointestinal bleeding in the aged]. 149 79

A 58-year-old man manifested obstructive jaundice secondary to adenocarcinoma of the common hepatic duct. The markedly icteric patient underwent multiple diagnostic and therapeutic procedures, including percutaneous needle biopsy of the liver, curettage, catheterization and washing of the hepatic ducts, and percutaneous transhepatic cholangiography. Three months later the patient died of a bleeding gastric ulcer. Autopsy confirmed the presence of adenocarcinoma of the common hepatic duct. Microscopic examination of the lungs disclosed numerous bile emboli in the smaller arteries, arterioles, and in a few alveolar capillaries. Histochemical reaction of the emboli was positive for bilirubin. Organizing fibrin was seen around occasional bile emboli, but most were without microscopic reaction. Review of the literature disclosed nine cases of pulmonary bile embolism, six of which had a history of marked cholestasis and trauma to the liver, like the present patient. Bile reaches the systemic circulation through a biliary-venous fistula that, in our case, was probably iatrogenic.
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PMID:Pulmonary bile emboli. Sequelae of iatrogenic trauma. 638 59

Gastric mucosal defensive factor plays an important role in the pathogenesis of various gastric diseases as well as aggressive factor such as acid. Gastric mucosal defensive factor of various gastric diseases and the relation to acid secretion were studied. The influence of operative insult and obstructive jaundice on gastric aggressive and defensive factors was also studied. Defensive factor was investigated using gastric transmucosal potential difference (PD). The results obtained were as follows: PD showed low value in the gastric diseases with the mucosal lesion such as gastric ulcer, stress ulcer and bleeding gastric ulcer. Particularly the last two diseases, which had active mucosal bleeding, showed remarkably low values. PD tended to increase following acid secretion but had no significance. Operative insult seemed to cause transient increase of intragastric pH and deterioration of gastric defensive factor, and the change was enhanced by obstructive jaundice.
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PMID:[Gastric mucosal defensive factor in various gastric diseases--with special reference to the influence of the operative insult and obstructive jaundice]. 647 52

Prognostic indicator for acute gastric ulceration was experimentally investigated using water immersed and restrained rats, with special interest in influence of obstructive jaundice and effect of vagotomy. The results obtained are as follows: Intragastric pH and gastric mucosal potential difference (PD) faithfully reflected the ulcer index. This shows that continuous monitoring of these two parameters may be of clinical use as indicator for acute gastric ulceration in critically ill or postoperative patients. Water immersing and restraint stress ulcer may be caused by imbalance between gastric offensive and defensive factors as a result of progressively increasing gastric secretion and progressively deteriorating gastric mucosal barrier. Gastric ulceration was enhanced in rats with obstructive jaundice, probably because of compromised defensive factor. Prophylaxis of acute gastric ulceration with or without obstructive jaundice may not be attained by vagotomy alone; an adequate maintenance of defensive factor seems to be also necessary.
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PMID:[Experimental study on acute gastric ulceration in rat--including influence of obstructive jaundice and vagotomy]. 667 85

Obstructive jaundice due to hilar cholangiocarcinoma is difficult to decompress because of the location of the tumor. We used external radiation alone for biliary decompression and reviewed its efficacy in this study. Subjects comprised 14 patients diagnosed as having inoperable hilar cholangiocarcinoma by ultrasonography, percutaneous transhepatic cholangiography, and CT scanning. The total bilirubin level on admission ranged from 0.4 to 34.6 mg/dl (mean: 11.0 mg/dl). These patients were irradiated with a 4MeV linear accelerator using parallel opposing fields measuring from 7 x 7 cm to 8 x 10 cm. The total radiation dose ranged from 50 Gy to 60 Gy and in fractions of 1.8-2.0 Gy per day. No patient underwent further biliary decompression after percutaneous transhepatic cholangiography, and irradiation was performed immediately after diagnosis. Eleven of the 14 patients received the full dose of external radiation. Three patients discontinued radiotherapy because of severe vomiting and nausea, pneumonia, and a hemorrhagic gastric ulcer. In 10 of the 11 patients, the serum total bilirubin level returned to normal (p < 0.005) and no cholangitis occurred. Obstructive jaundice recurred in one patient, and serum total bilirubin returned to normal again after further irradiation. Eight of the 11 patients could be discharged from hospital and returned to society. The survival time of the 11 patients ranged from 3 to 25 months and the 12-month survival rate was 50% (Kaplan-Meier method). This study suggests that external radiation therapy is an effective treatment for biliary decompression in patients with unresectable hilar cholangiocarcinoma.
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PMID:External radiotherapy for biliary decompression of hilar cholangiocarcinoma. 759 May 76