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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over a period of 20 years, 1,109 operations were performed for peptic ulcer. The site was duodenal in 873, gastric in 161 and marginal in 75. Eighty-three closures of perforations resulted in eight deaths and 28 second operations. Excluding closure of perforation and operation for marginal ulcer, the definitive operations and postoperative mortality were 446 gastric resections and 3.5 per cent; 181 truncal vagotomy with gastric resection and 1.6 per cent, and 326 truncal vagotomy with drainage and 3.2 per cent. Recurrence after operation for gastric ulcer was 5.3 per cent and for duodenal ulcer, 7.2 per cent. Based on the total number of operations for duodenal ulcer, a recurrence occurred after 348 gastric resections, 9.2 per cent; after 146 vagotomy with resection, 2.0 per cent, and after 309 vagotomy with drainage, 7.4 per cent.
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PMID:Retrospective study of operations for peptic ulcer. 50 44

In our hospital the incidence of upper digestive hemorhage [UDH] is greater after the 4th decade of age and predominantes in the male sex. The patients' clinical data was important in the diagnosis of the lesion. In 63% of our cases a close relation was found between the previous intake of substances considered ulcerogenous and the hemorrhagic episode, as well as the presence of stress situations. In our experiences the causes of UDH in order of their frequency are: 1. Acute lesions of the gastric mucosa. 2. Duodenal ulcer. 3. Gastric ulcer. 4. Stomal ulcer. 5. Bleeding esophagitis. 6. Others. The digestive hemorrhages of undetermined caused corresponded to 2,33% of the cases. The early diagnosis of UDH by means of emergency endoscope was of great value in the therapeutic handling of patients.
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PMID:[Emergency endoscopy in upper digestive hemorrhage]. 82 64

By the early part of this century, members of the Southern Surgical Association as well as others began to realize that gastroenterostomy alone was unacceptable for the treatment of gastric ulcer. Ulcer excision and some type of limited resection was advised. At a later date, gastric resection of varying extent, depending on ulcer size and location, became the appropriate treatment for complications of this disease. For treatment of complications of duodenal ulcer, gastroenterostomy was widely used from the latter part of the 19th century until the late 1930s. Adequate gastric resection slowly but cautiously replaced gastroenterostomy during the 1940s. Vagotomy with drainage and vagotomy with antrectomy slowly developed and replaced adequate resection by the early 1970s. Beginning in the 1970s and extending into the 1980s, fewer duodenal ulcers were seen, and many of those encountered were being adequately managed using the H2 receptor blockers. For the intractable duodenal ulcer there is currently an increasing trend to use the less invasive operation of parietal cell vagotomy. Vagotomy with antrectomy for such cases is being used less frequently. Vagotomy and drainage has lost much of its appeal. Lesser procedures have been advocated recently for treatment of marginal ulcer after incomplete vagotomy irrespective of the original operation for ulcer. Massive bleeding and acute perforation are still frequently encountered as complications but are being seen more frequently in elderly high-risk patients, some of whom will tolerate only a lesser procedure as suture ligation, vagotomy with drainage, or simple ulcer closure. It appears that we are now seeing a different duodenal ulcer pattern in the good-risk patient. The ulcers are usually small, less virulent, and less likely to be found penetrating into the pancreas and adjacent organ structures. As Claude Welch so aptly stated recently before the Association, "We are seeing a trend in ulcer surgery that is currently being seen in other areas of surgical endeavors as well." He emphasized that we must be alert to changing disease patterns and adapt our procedures to new requirements.
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PMID:Gastroduodenal ulcer. Overview of 150 papers presented before the Southern Surgical Association 1888-1986. 329 96

Endoscopic dehydrated ethanol injection was attempted in 48 patients with substantial bleeding of the upper gastrointestinal tract; most of the patients had associated serious medical conditions. The causes of bleeding were: gastric ulcer in 17; duodenal ulcer in 11; gastric or duodenal vascular ectasias, or both, in five; Mallory-Weiss tear in three; acute gastric mucosal lesion in six; esophageal ulcer in two; marginal ulcer in two; gastric leiomyoma in one, and carcinoma of the stomach in one. The mean age was 57 years old (a range of 18 to 91 years old). The mean amount of blood loss prior to time of injection was 4.5 units (a range of 3 to 10 units). Ethanol injection was initially successful in 45 of 48 patients but rebleeding occurred within 72 hours in three of these patients. All instances of treated vascular ectasia disappeared by the time of follow-up endoscopy. No complications were attributable to the injections. Endoscopic local ethanol injection may be the treatment of choice in selected patients with bleeding of the upper gastrointestinal tract.
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PMID:Endoscopic hemostasis of bleeding of the upper gastrointestinal tract by local injection of ninety-eight per cent dehydrated ethanol. 351 55

An uncontrolled study for the assessment of the hemostatic effects of endoscopically injected hypertonic saline-epinephrine (HS-E) solution and pure ethanol (PE) was carried out in 67 patients with nonvariceal gastrointestinal bleeding. The HS-E group included duodenal ulcer (18), gastric ulcer (9), gastric cancer (2), polyp (2), marginal ulcer (1), and esophageal cancer (1). Bleeding was active in 15 (pulsating, 3; oozing, 12). The hemostatic effect was permanent in 29 cases (87.9%) but failed in four cases (12.1%). The PE group consisted of 34 patients with duodenal ulcer (25), gastric ulcer (4), polyp (2), marginal ulcer (2), and gastric cancer (1). There was active bleeding in 14 (pulsating, 3; oozing, 11). The hemostatic effect was permanent in 31 cases (91.2%), temporary in 1 case (2.9%), and failed in 2 cases (5.9%). We conclude that endoscopic local injection with HS-E or PE is a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal gastrointestinal bleeding.
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PMID:Hemostatic effect of endoscopic local injection with hypertonic saline-epinephrine solution and pure ethanol for digestive tract bleeding. 353 2