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

Fungal gastric ulcer is a relatively frequent from of gastric mycosis coexisting in 20-30% of cases with peptic ulcer. In such cases fungi were present in patients without other disease and in those with concomitant diseases such as neoplasms, polyps of the stomach, haematological diseases, and in patients treated with cytostatics and H2-blockers. Fungal ulcer differ from common ulcers in greater size and tendency for bleeding. In certain situations "fungal ulcer" requires routine antimycotic treatment especially if operation is planned.
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PMID:[Fungal stomach ulcer]. 144 28

We describe a case of pneumopyopericarditis caused by a mixture of fungal and bacterial pathogens. This originated from a gastric ulcer (within a hiatus hernia) which had eroded into the pericardial sac. Further complications included the late discovery of the ulcer and asplenism. Similar cases have been reported, but to the best of the authors' knowledge, none with an actual mixture of the two pathogens.
Mycoses
PMID:Penetrating gastric ulcer as a cause of mixed bacterial and fungal pericarditis. 174 91

The results of a 5-year follow-up of 289 consecutive, peptic ulcer patients treated by antrectomy and gastroduodenostomy, with or without vagotomy, are presented. Patients with a preoperative gastric acid secretory capacity (PAO) below 40 mmol/h were treated by antrectomy alone, while subjects with a higher PAO had a vagotomy in addition. The antrectomy was defined by lithmus indication of the corpus-antrum border and by histologic verification, including gastrin cell counting. The over all incidence of gastroscopically verified recurrent ulceration was 8.5%. In patients with ulcer location in the bulb or the pyloric/prepyloric region (juxtapyloric ulcer) and treated by antrectomy alone, the recurrence rate was 18% (n = 102), and in gastric ulcer patients it was 4% (n = 47). Altogether 14 patients with recurrent ulcer were subsequently reoperated on by vagotomy showing no further recurrence. Antrectomy combined with vagotomy was primarily performed almost exclusively in patients with juxtapyloric ulceration, in whom the recurrence rate was 2% (n = 106). According to a postoperative insulin test, the patients with recurrence after antrectomy and vagotomy were incompletely vagotomized. In patients who remained free of symptoms or signs of recurrent disease, the median reduction in gastric acid secretory capacity was about 60% after antrectomy alone and 80% after antrectomy and vagotomy. In juxtapyloric ulcer patients with recurrence after antrectomy alone there was a small median reduction in PAO one month after operation (26%) and then an increase close to the preoperative level (6% reduction). In patients with a postoperative reduction in PAO of less than 35%, there was a high probability of recurrent ulcer, about 70%. In spite of selection of patients with a comparatively low preoperative PAO (less than 40 mmol/h) for antrectomy alone, the recurrence rate was 18% in patients with juxtapyloric ulcer location. In this selected group of patients the preoperative PAO was not higher in patients with ulcer recurrence than in patients who were asymptomatic after the operation. Selecting patients with juxtapyloric ulcer for antrectomy, with or without vagotomy, on the basis of gastric acid secretory capacity therefore seems unjustified. When vagotomy was added to antrectomy and gastroduodenostomy it seemed to increase the risk of developing serious (Visick 3u and 4) postgastrectomy syndromes; 12% after antrectomy and vagotomy versus 3% after antrectomy alone. Vagotomy appeared to be associated with an increased risk of bile reflux gastritis, gastric mycosis, and milk intolerance. Dumping and diarrhoea after vagotomy often coincided with milk intolerance. Antrectomy, with or without vagotomy, did not markedly impair recorded nutritional parameters.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Antrectomy and gastroduodenostomy with or without vagotomy in peptic ulcer disease. A prospective study with a 5-year follow-up. 657 6

121 cases of candidiasis were histologically demonstrated in the course of histological studies of gastric mucosal biopsies in 20 401 patients. Infestation of necrotic tissue with Candida albicans was found exclusively in patients with gastric ulcer, ulcerating carcinoma or lymphoma. Candidiasis was twice as common in carcinoma as in non-carcinomatous gastric ulcer. In the majority of those patients with ulcer who also had Candida albicans mycosis there was was at the same time atrophic or dysplastic gastric mucosa at the edge of the ulcer. Demonstration of candidiasis in biopsy material from gastric ulcer should thus be interpreted as suspicious of carcinoma, until and unless further studies confirm or exclude it.
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PMID:[Incidence and significance of candidiasis in biopsy material of gastric ulcers (author's transl)]. 743 71

A prospective study was performed to evaluate the prevalence of fungal infection in gastric ulceration and its effect on ulcer healing in 178 benign and 97 malignant gastric ulcers. Fungal infection was defined as presence of fungal hyphae or spores in the biopsy forceps specimen. For patients with benign gastric ulcers, sucralfate 1 g q.i.d. was prescribed and a second panendoscopy examination was carried out after 6 weeks to evaluate ulcer healing. Fungal colonization was found in 36 (20.2%) patients with benign gastric ulcers and 26 (26.8%) patients with gastric cancers (p > 0.2). The mean age of patients with benign gastric ulcer with fungal infection (group I) was 64.2 +/- 11.4 years, whereas the mean age of those without fungal infection (group II) was 56.2 +/- 13.1 years (p < 0.01). Follow-up panendoscopy after 6 weeks of sucralfate therapy revealed 6 of 24 patients (25%) in group I and 19 of 81 patients (23%) in group II with unsatisfactory healing (difference not significant). Comparison of confounding factors such as smoking, daily tea or coffee intake, underlying disease, ulcer location, and endoscopic appearance between these two groups revealed no significant differences. In conclusion, the presence of fungus in gastric ulcers is a secondary phenomenon and it does not affect ulcer healing.
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PMID:A prospective study of fungal infection of gastric ulcers: clinical significance and correlation with medical treatment. 755 78

The aim of this study was to estimate the frequency of fungal colonization of the stomach of patients suffering from gastric ulcer (GU) and chronic gastritis (CG) and the influence of fungal colonization of the stomach on the process of ulcer healing. We investigated 293 patients aged 20-80 years. Before and after 4 weeks of sucralfate treatment they underwent endoscopy of the stomach, histological examination of biopsies taken from the ulcer margin or inflamed gastric mucosa and mycological examinations of the gastric juice, surface brushing and biopsies. The studies revealed a high concentration of fungi in 54.2% patients with GU and 10.3% with CG. Candida albicans was the most frequently isolated organism. Fungal colonization of the stomach impairs the process of gastric ulcer healing. Control examination after 4 weeks of sucralfate therapy showed the ratio of GU healing in 62% of patients with a high concentration of fungi in comparison with 78% of patients not colonized with fungi (P < 0.05). A significantly longer duration of ulcer symptoms in the group of patients with a high concentration of fungi in the stomach was also observed. There was no correlation between the level of fungal antibodies, of Candida antigen in the serum and the concentration of fungi in the stomach.
Mycoses
PMID:Fungal colonization of the stomach and its clinical relevance. 986 39

A case of benign gastric ulcer associated with Candida infection in a healthy adult is reported. The patient was a 46-year-old man complaining of epigastralgia. Endoscopic examination of the upper digestive tract revealed an elevated lesion with ulceration having an unclear border and thick exudates. The clinical diagnosis based on endoscopic findings was a benign gastric ulcer; however, biopsy was performed to distinguish it from malignant lymphoma. Histological examination of biopsy samples obtained from the base and the edge of the ulcer revealed numerous Candida. Therefore, the patient was diagnosed with Candida-infected gastric ulcer. The ulcer resolved after the administration of antiulcer drugs for 2 months. Predisposing factors for fungal infection were excluded. These observations suggest that Candida-infected gastric ulcer should be suspected in patients with a gastric submucosal tumor-like lesion with a thick, yellowish-white coated ulcer of unclear border on its summit, and this lesion should be distinguished from malignant diseases.
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PMID:Benign gastric ulcer associated with Canidida infection in a healthy adult. 1058 85

Certain general and local factors can increase the probability of complications of gastric ulcer (GU) and addition of conditionally pathogenic fungi (CPF), which requires direct examination of GU patients for fungous infections. Considering that addition of active CPF forms to ulcerous defects lead to enlargement and deepening of ulcers and postpones their healing, all patients with GU complicated by addition of CPF were administered antifungal drugs. A comparative study found no significant differences in the efficacy of eradication of fungal infection between system (resorbable) and luminal (non-resorbable) antimycotics.
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PMID:[The efficacy of antifungal therapy in treatment of gastric ulcer]. 1768 92

Gastric mucormycosis is a rare and life-threatening fungal disease, caused by fungus in the order Mucorales. While rhino-cerebral and pulmonary forms are common, gastric mucormycosis is an uncommon site for the disease. We diagnosed gastric mucormycosis in a 41-year-old female who had severe multiple trauma, including cardiac rupture, due to a traffic accident. Eighteen days after hospitalization, she passed 800 mL of melena over one day. We performed upper esophagogastroduodenoscopy (EGD) and found a huge gastric ulcer with bleeding. Histopathological examination identified non-septated and right-angled branching fungal hyphae, and we diagnosed gastric mucormycosis. We recommended total gastrectomy to her but she refused the operation, so she was treated with liposomal amphotericin B for 53 days. After two months of treatment with liposomal amphotericin B, we again performed EGD and found a healed gastric ulcer. After four months, with another EGD, we found that the gastric mucormycosis was completely healed.
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PMID:[Gastric Mucormycosis Followed by Traumatic Cardiac Rupture in an Immunocompetent Patient]. 2755 17

Mucormycosis, is an emerging fungal infection in immunocompromised and diabetic individuals, usually affects rhino-orbito-cerebral, cutaneous and pulmonary regions. But mucormycosis in immunocompetent environment is rare and occurrence of gastric mucormycosis is unusual. We report a case of 19 year old female, with no pre-existing co-morbidities, presented with fever, dysentery, vomiting, and melena for 4 days. On evaluation she was found to have pancytopenia, acute kidney injury, hemolytic anemia, coagulopathy and hepatic derangement and treated with hemodialysis, plasmapheresis along with antibiotics and packed cell RBC transfusion. Upper gastrointestinal endoscopy revealed presence of extensive esophageal and gastric ulcer. In view of persistent bleeding despite endoscopic sclerotherapy, repetition of upper gastrointestinal endoscopy and CT abdomen with oral contrast was done, which revealed perforated gastric ulcer. Exploratory laparotomy and excision of ulcer was done. The biopsy of gastric ulcer had shown the presence of granulomatous necrotic areas positive for mucormycosis. Then she was managed with amphotericin-B, posoconazole with which she improved.
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PMID:Gastric Mucormycosis with Hemolytic Uremic Syndrome. 2760 99


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