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)

We analyzed 321 consecutive episodes of community-based acute upper gastrointestinal bleeding admitted to the Hadassah University Hospital in Jerusalem during 1988-91. Of these 71% were in males aged 56.2 +/- 1.2 years (mean +/- SE) and 29% were in females (67.9 +/- 1.7 years, P < 0.001). The main diagnoses were duodenal ulcer (39.5%), gastric ulcer (16.9%), esophageal varices (10.0%), erosive gastritis (8.2%) and esophagitis (7.5%). The distribution of these diagnoses differed significantly between the genders (P = 0.0003). In males the prevalence of duodenal ulcer and of esophageal varices was higher, and that of gastric ulcer and esophagitis lower, than in females. Gastric ulcer patients were oldest, were the least likely to have received anti-ulcer medications prior to admission, and had the highest levels of urea and the lowest levels of hemoglobin on admission. Use of nonsteroidal anti-inflammatory drugs increased significantly with age and was reported in 35% of the cases (aspirin in doses < 1.0 g/day in 21%, nonsalicylate anti-inflammatory agents in 11%, aspirin plus other anti-inflammatory drugs in 3%). Use of systemic corticosteroids was reported in 4%. The most distinctive features of the population with acute upper gastrointestinal bleeding in the present study compared to other series were the significantly higher proportion of duodenal ulcers and the lower proportion of Mallory-Weiss tears.
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PMID:Acute upper gastrointestinal bleeding in Jerusalem 1988-91: causes, characteristics and relation to nonsteroidal anti-inflammatory drugs. 831 97

In 1982 four Japanese authors Okaba, Honda, Toshiba and Asami reported at the International Symposium in Tokyo on successful transendoscopic sclerosification of bleeding ulcer, around which a sclerosifying agent or absolute alcohol was injected with or without epinephrine. Alcohol suppresses bleeding, causing local dehydration, coagulation and sclerosis of the bleeding tissue, thus producing hemostasis. For the last two years the authors have gained some experience in the application of periulcer and peritumor sclerosification with the sclerosifying agent etoxysclerol (3 per cent solution) and pure 96 per cent ethanol + 1 ampoule epinephrine. As regards the bleeding site, patients with the following nosologic entities were treated: gastric ulcer--24 patients; duodenal ulcer--13; gastric cancer--6; anastomotic ulcer--2; acute ulcer--7; Mallory-Weiss syndrome--10 patients. The results may be summarized as follows: temporary hemostasis was achieved in 21 patients, bleeding recurred in 8 and 9 patients required emergency surgery. Complete and ultimate hemostasis was attained in 29 patients (46.7 per cent). Nine patients died of hemorrhage.
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PMID:[The immediate results of transendoscopic sclerotherapy in hemorrhaging varices, tumors and polyps and in the Mallory-Weiss syndrome]. 841 56

For a period of 10 years (1980-1990) a total of 2034 emergency, early and postponed endoscopies have been performed in patients with upper digestive tract bleeding at the Department of Emergency Surgery in Sofia. Duodenal ulcer has been the leading cause of bleeding--41.19 per cent of the cases, with gastric ulcer ranking second--14.94 per cent. There followed in descending rank order: gastric and duodenal erosions--12.34 per cent; gastric cancer--5.06 per cent; hemorrhagic gastritis--2.56 per cent; esophageal varices--7.27 per cent; Mallory-Weiss syndrome--1.62 per cent. Bleeding from the digestive tract of patients with CNS trauma based on acute stress ulcer and erosions and activated old callous ulcer occupied the 12th place in rank order. On the 13th place ranked upper digestive tract bleeding in patients who had undergone thermic trauma (2.01 per cent). Much fewer wer the cases of bleeding secondary to peptic ulcer of the jejunum, gastric and duodenal diverticulosis, acute ulcers in patients with cardiovascular diseases, blood diseases, liver, bile duct and pancreas diseases, aorto-duodenal fistulas and drug-induced diseases. The cause remained unknown in 1.77 per cent of the patients. On the basis of the indisputable achievements in [correction of ti] the diagnosis of acute upper digestive tract hemorrhage, the approach to these grave nosologic entities has essentially been altered.
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PMID:[The results and a discussion of the esophagogastroduodenoscopic studies performed successfully, early and postponed in patients with upper digestive tract hemorrhages in 1980-1990]. 841 75

The aims of this prospective study were to determine the patterns of gastrointestinal (GI) bleeding in hemophiliacs and to assess the hemostatic effect of injection therapy with alcohol. During a 5-year period (1990-1994) 89 hemophiliacs were admitted to our department with acute GI bleeding. Among these patients duodenal ulcer was found endoscopically to be the most common (42.7%) cause of hemorrhage; gastric ulcer was the source of the bleeding in only three patients (3.4%). A group of 46 patients met the criteria of active or recent bleeding and underwent injection therapy with alcohol. The injected bleeding lesions were duodenal ulcer in 32 patients, duodenal erosion in 2, gastric ulcer in 3, and other gastric lesions (Mallory-Weiss tear, Dieulafoy lesion, stomal ulcer, erosions) in 9 patients. Initial hemostasis was achieved in 100% and permanent hemostasis in 82.6%. Rebleeding was observed in eight patients (17.4%), with five of them successfully treated by reinjections. Three patients (6.5%) required emergency surgery. The mortality rate in the group of injected patients was 2.2%. One patient died of stroke on day 10 after partial gastrectomy. All injected patients were given replacement therapy with factor VIII or IX for 2 days (29 patients) or 7 to 14 days (17 patients). Analysis of the hemostatic effect achieved in these two subgroups indicate that short-term replacement therapy (2 days) may be sufficient to ensure adequate hemostasis in hemophiliacs. The results of the present study indicate that injection therapy with alcohol is an effective, safe, proved method to control GI bleeding in hemophiliacs.
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PMID:Endoscopic injection treatment of gastrointestinal bleeding in hemophiliacs. 886 77

Mallory-Weiss Syndrome (MWS) lesions account for up to 15 per cent of upper gastrointestinal bleeding episodes. Typically these lesions present as a consequence of vomiting that is often associated with alcoholism. Recently other conditions such as pregnancy, migraine, hiatal hernia, gastric ulcer, biliary disease, and various medications have been associated with MWS. We report on a 32-year-old male who developed a MSW lesion after a prolonged period of swimming followed by an extended commercial airplane flight. The hemodynamic changes associated with swimming (increased central distribution of blood volume) and the pressure changes in commercial aircraft (a reduction of 0.3 atmospheres of pressure) are discussed. We conclude that the combination of these factors contributed to the development of a MWS lesion and gastrointestinal bleeding in this patient. We recommend that both air travel and athletic activities be considered as possible contributing factors in the evaluation of the cause of new-onset gastrointestinal bleeding.
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PMID:Mallory-Weiss syndrome: possible link to water immersion and subsequent air flight. 1109 26

108 patients suffering from the cirrhosis of the liver and acute bleeding into the upper digestive tract underwent a prospective endoscopic examination with diagnostic and therapeutic objectives. The most frequent causes of acute bleeding included oesophagus varices (57.4%) followed by peptic gastric ulcer (13.9%) and peptic ulcer of duodenum (11.1%), then portal hypertension gastropathy (5.6%), gastric varices (4.6%), reflux oesophagitis (2.8%), Mallory-Weiss syndrom (2.8%) and erosive gastropathy (0.9%). The endoscopy of the upper digestive tract in one patient resulted in negative diagnosis. 69% of examinations showed multiple findings in the upper digestive tract, each of which could have been a potential cause of bleeding. To determine the source of bleeding the specialist's attitude presented at the end of the endoscopic examination was taken into consideration. In 67.6% of patients the bleeding was a direct consequence of portal hypertension, in 62% it was caused by varices. The emphasis is put on early and thorough endoscopic examinations aimed at proper diagnosis and therapy.
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PMID:[The etiology of upper gastrointestinal bleeding in patients with liver cirrhosis]. 1835 62

The present study was designed to evaluate the usefulness and safety of bipolar hemostatic forceps, known as a less invasive and highly safe means of thermal coagulation used for hemostasis in cases of non-variceal upper gastrointestinal bleeding. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis. The study involved 39 cases where hemostasis was attempted with bipolar forceps to deal with non-variceal upper gastrointestinal bleeding, including 28 cases of gastric ulcer, six cases of duodenal ulcer, three cases of bleeding after endoscopic submucosal dissection (ESD), one case of Mallory-Weiss syndrome and one case of postoperative bleeding from the anastomosed area. There were 34 males and five females, with a mean age of 63.6 years. Bipolar forceps were the first-line means of hemostasis in cases of oozing bleeding (venous bleeding), pulsatile or spurting bleeding (arterial bleeding) and exposed vessels without active bleeding. The primary hemostasis success rate was 92.3%, and the re-bleeding rate was 0%. In cases where the bleeding site was located along the tangential line or in cases where large respiration-caused motions hampered identification of the bleeding site, hemostasis by means of coagulation was easily effected by application of electricity while the forceps were kept open and compressed the bleeding area. In addition, there were no complications. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis.
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PMID:Clinical evaluation of emergency endoscopic hemostasis with bipolar forceps in non-variceal upper gastrointestinal bleeding. 2044 13

In the course of aggressive treatment for acute leukemia, the ensuing pancytopenia and intensive medical support may be accompanied by severe gastrointestinal (GI) complications. Therefore, to assess the safety and efficacy of GI endoscopy as a means of diagnosis, we analyzed the records of 16 patients undergoing 27 endoscopies a mean (+/-S.D.) of 18.4 +/- 11.9 days post chemotherapy. There were 6 procedures performed in patients with acute lymphocytic, 18 with acute myelogenous, including 3 with acute promyelocytic and 3 with blastic phase chronic myelogenous leukemia. 10/27 procedures were performed in patients with less than 1000 WBC/mm3 and 19/27 had less than 100,000 platelets. 15 patients had 25 upper endoscopies done for: bleeding (twenty-one), abdominal pain (two), and persistent vomiting (two). The principal bleeding sources were: esophagitis (eleven), Mallory Weiss tear (one), gastritis (three), gastric ulcer (one), duodenal ulcer (five). In the non-bleeding cases 2 exams were normal and the others had gastritis (one) and esophagitis (one). 15/25 procedures (64%) resulted in new diagnosis and 20/25 (80%) in additional therapies. 47% of patients undergoing upper GI endoscopy received specific new therapies as a result of that procedure. Nd: YAG laser photocoagulation was effective in stopping bleeding lesions in 4/6 cases. 10/12 bleeding patients had persistent or recurrent bleeding and 2 died from bleeding. None had surgery. Two patients underwent colonoscopy, both for colonic distention. One patient, who had been recently treated for Cl. difficile had submucosal petechiae. The other had non-specific colitis. No biopsies were done and both cases were successfully decompressed..No complications occurred from any GI endoscopy. We conclude that GI endoscopy can be safely performed in patients with acute leukemia, resulting in specific diagnoses and therapies. Esophagitis is a principal cause of GI bleeding in these patients. The role of therapeutic endoscopy in controlling bleeding is promising but requires further evaluation.
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PMID:The safety and efficacy of gi endoscopy in patients with acute-leukemia - a review of 27 cases. 2158 64

Upper gastro-intestinal (GI) bleeding is a life-threatening emergency that results in high morbidity and mortality and therefore requires admission to hospital for urgent diagnosis and management. The aim of this study was to determine the causes of upper GI bleeding and clinical outcome of patients admitted to medical department with the diagnosis of upper GI bleeding. A retrospective study of records of all upper GI bleeding patients who were admitted to medical department, Kilimanjaro Christian Medical Centre (KCMC) from January 2007 to December 2008 was conducted. A total of 130 patients (13-96 years old) were enrolled in the study, whereby 73 (56.2%) were males. The causes of bleeding, all endoscopically diagnosed included oesophageal varices in 55 (42.3%) cases, followed by duodenal ulcers 20 (15.4%), hemorrhagic/erosive gastritis 10 (7.7%), gastric ulcer 6 (4.6%) and Mallory Weiss tear 2 (1.5%). No cause was identified in the remaining 27 % of cases. Conservative medical therapy alone was carried out in 52.3% of the patients. Endoscopic therapy was used in 61 (46.9%) of patients. Only 2 (1.5%) patients underwent surgical intervention. The overall mortality at discharge was 17%, while 107 (82%) patients were discharged improved. In conclusion, the commonest causes of upper GI bleeding are oesophageal varices and duodenal ulcer. Most cases of upper GI bleeding were successfully treated with pharmacologic and endoscopic treatment. The high mortality may be influenced by delayed presentation to health facilities, and comorbidities. There is a need for strengthening preventive programmes and conducting studies to identify predictors of outcome of upper GI bleeding to develop evidence based management protocols.
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PMID:The aetiology, management and clinical outcome of upper gastrointestinal bleeding among patients admitted at the Kilimanjaro Christian Medical Centre in Moshi, Tanzania. 2440 39

Esophageal and gastric varix, portal hypertensive gastropathy, Mallory-Weiss tear and gastric ulcer are common causes of bleeding in patients with liver cirrhosis. However, spontaneous arterial bleeding without a history of trauma is a rare cause of bleeding which can be fatal. We report a case of a 55-year-old woman with alcoholic liver cirrhosis who developed spontaneous bleeding of multiple right lumbar arteries and died in spite of repetitive transfusion and embolization.
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PMID:[A case of spontaneous bleeding of multiple lumbar arteries in a patient with liver cirrhosis]. 2579 84


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