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)

The purpose of this paper is to study the use of upper gastrointestinal (Gl) fiberoptic endoscopy in children. Two hundred consecutive patients referred to one of the authors were reviewed. The indications for performing upper gastrointestinal endoscopy in these 200 patients were: (1) recurrent abdominal pain (46.5%), (2) persistent vomiting (14.5%), (3) haematemesis (14.5%), (4) acute abdominal pain (13%) and (5) other indications such as foreign body removal, failure to thrive and unexplained chest pain (11.5%). The endoscopy was performed with the Olympus P3 or Olympus XP-10 gastroscopes. The sedation used was a combination of intravenous pethidine (2mg/kg) and diazepam (0.5 mg/kg). Among the patients with recurrent abdominal pain, upper Gl endoscopy showed duodenal ulcer in 7 patients (7.5%), duodenitis in 4 (4.3%), oesophagitis in 4 (4.3%) and gastric ulcer in 2 (2.2%). The rest of the patients were normal (81.7%). With regard to persistent vomiting, 37.9% of the patients showed gastroesophageal reflux and 6.9% had a hiatus hernia. Of 29 patients examined endoscopically for upper Gl bleeding, no focus of bleeding was identified in 27.6%. The remaining 72.4% were bleeding from acute gastric erosion (27.6%), oesophagitis (17.2%), oesophageal varices (13.8%), duodenal ulcer (10.3%) and Mallory-Weiss tear (3.5%). The Majority of the patients with acute abdominal pain were normal endoscopically (61.5%). The two common abnormal findings were acute gastritis (27.0%) and acute duodenitis (11.5%). No major complications were encountered during the procedure in these 200 patients. It was concluded that upper Gl endoscopy is useful for defining upper Gl mucosal pathology. The procedure can be performed safely in children under sedation.
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PMID:Upper gastrointestinal endoscopy in children. 237 74

A 67-year-old woman was admitted to our hospital with chest pain and dyspnea which occurred suddenly after vomiting. She was well until admission except for cholelithiasis and hypertension which had been pointed out 3 years earlier. Arterial blood gas analysis showed hypoxemia without hypercapnea. Chest X-ray examination on admission revealed intra-mediastinal air with a niveau behind the heart which compressed the vasculature of the left lower lobe and a small amount of air in the regions adjacent to the trachea, left main bronchus and aortic arch. The serial chest radiographs showed pneumomediastinum, subcutaneous emphysema, pneumothorax and pleural effusion in that order within 16 hours after the onset. The diagnosis of esophageal rupture was made by CT scan of the chest performed after oral administration of Gastrografin, which demonstrated extravasation of contrast medium into the mediastinum. Surgical treatment including eversion stripping and esophagogastrostomy was performed 23 hours after the onset. Pathological examination of the removed specimens revealed a rupture of the lower portion of the esophagus originated in the gastric ulcer of the cardia. In spite of intensive care, she died 45 days after surgery because of renal failure. It was considered that the most important point in the early diagnosis of esophageal rupture was to suspect this disease based on the gastric symptoms followed by the respiratory symptoms and to demonstrate pneumomediastinum in chest X-ray. Chest CT scan performed after the oral administration of contrast medium could be an useful and non-invasive diagnostic procedure.
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PMID:[A case of esophageal rupture confirmed by chest CT: characteristic changes in chest radiographs]. 261 3

The long-term prognosis for cardiac death was prospectively evaluated in three subpopulations admitted to a coronary care unit with chest pain under suspicion of acute myocardial infarction (AMI) with (1) confirmed AMI (n = 275), (2) AMI ruled out, but suspicion of coronary artery disease (n = 257) and (3) AMI ruled out and an obvious noncoronary reason for chest pain (n = 63). The latter subgroup included patients with pericarditis, valvular disease, arrhythmia, pneumonia, pulmonary embolism, gastric ulcer and musculoskeletal disorders. The 7-year cardiac mortality rates of the three subpopulations were 34, 17 and 32%, respectively (p < 0.0001). Despite the 'benign' nature of the chest pain, the cardiac mortality was high in all diagnostic categories of noncoronary chest pain. In conclusion, patients admitted with chest pain of apparently noncoronary origin are at high risk for later cardiac death. This indicates the presence of severe coronary artery disease in some of the patients. Consequently, all patients with chest pain and AMI ruled out should be evaluated carefully regarding coronary artery disease at the time of discharge.
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PMID:Long-term cardiac mortality in patients admitted with noncoronary chest pain under suspicion of acute myocardial infarction. 851 8

A 76-year-old female was admitted to our hospital due to anterior chest pain and dyspnea. Mitral regurgitation due to prolapse of the posterior leaflet was detected by UCG. After admission, massive gastric hemorrhage was observed. Because hemostatic therapy using endoscopy was not effective, partial gastrectomy was performed. The origin of the hemorrhage, an acute gastric ulcer, was located on the side of the minor curvature of the corpus ventriculi. After gastrectomy, the patient underwent medical treatment using an IABP, but the left heart failure was not reduced, and the pulmonary edema worsened. At 18 hours after gastrectomy, MVR was performed. The cause of regurgitation is torn chordae of the posterior leaflet. The postoperative course was good, and the patient is doing well in NYHA class 1. This case is the first report of acute mitral insufficiency associated with acute gastric lesion in Japan.
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PMID:[A case report of surgical treatment for acute mitral insufficiency associated with acute gastric lesion]. 875 97

A 62-year-old man with complaints of severe chest pain came to our hospital. An emergency coronary angiography was performed and he was diagnosed as having acute myocardial infarction. Due to severe triple vessels disease he was referred to the department of Cardiovascular Surgery to undergo emergency coronary artery bypass grafting. In the coronary care unit, sudden hematoemesis due to hemorrhagic gastric ulcer occurred, however, just when he was going to be transferred to the operation room. Because the gastric bleeding was thought to be serious under extracorporeal circulation, which was indispensable for coronary artery bypass grafting, gastrotomy with suturing ulcer was performed prior to median sternotomy with use of intraaortic balloon pumping. Severe infection was not complicated. His postoperative course was uneventful.
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PMID:[Simultaneous operation of emergency coronary artery bypass grafting and gastrotomy with suturing ulcer]. 930 Nov 83

It is known that collections of popular medical prescriptions and instructions appeared in areas without educated physicians, and all previously published manuscripts of this kind are inevitably anonymous. The reported manuscript comprises 23 pages written in sepia ink, appendixed to a prayer book published in 1747, containing popular medical instructions and prescriptions collected and practiced by orthodox priest Mihailo Plamenac in Montenegro at the turn of the 18th century. Mihailo Plamenac took an important part in historical events, as documented by numerous domestic historical data and several letters discovered in The Archives of Vienna. Being the only literate persons at the time, priests were both politicians and military officers, but they also offered medical services to the population. The manuscript comprises advices for various common emergencies (snake bites, urinary retention, contusions, fever, burns, eye injuries, rabies, otitis, traumatic wryneck) and diseases(impetigo, scabies, infertility, gastric ulcer, low back pain) as well as for certain poorly defined conditions (chest pain, abdominal discomfort). Besides medically fully adequate treatment, for example, the remedy against scabies containing sulfur, there are numerous examples of magic and ritual pagan elements, including famous medieval SATOR formula against rabies. Most of the herbs used in prescriptions have been identified: fig, dog rose, hyssop, leek, laurel, absinthe, rosemary, mallow, cypress, elder, endive, mangel, orache, ivy. The manuscript is the first manuscript undoubtedly attributed to a well known historical personality, as indicated in the first page of the manuscript: "This is a medical prayer book by Mihailo Plamenac, left to him by his ancestors."
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PMID:[Medical manuscript of Mihail Plamenac, a priest]. 952 86

Pyopneumopericardium caused by transdiaphragmatic perforation of gastric ulcer is very rare. A 60-year-old man was admitted to our hospital because of chest pain with high fever. The chest computed tomography (CT) revealed hydropneumopericardium. The patient was diagnosed as purulent pericarditis. So emergent pericardiectomy and pericardial drainage were performed to relieve cardiac tamponade. Two findings enabled us to diagnose the causation of pyopneumopericardium as gastropericardial fistura. The first finding was that endoscopic examination of upper gastrointestinal tract revealed a deep peptic ulcer in the dome of gastric fundus. The second finding was that a dye solution which was injected into the pericardial cavity via the drainage tube leaked out into the gastric cavity through the ulcer. This patient improved successfully by the treatment of intravenous hyperalimentation including antibiotics and omeprazole. We think that expedient diagnosis and surgical drainage are essential for successful patient outcome.
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PMID:[Pyopneumopericardium caused by perforation of gastric ulcer; report of a case]. 1588 Dec 44

A 65-year-old woman, who had been taking non-steroidal anti-inflammatory drugs (NSAIDs), prednisolone and methotrexate for rheumatiod arthritis, was admitted to our hospital with a sudden onset of left-back and chest pain and breathlessness. A chest radiograph and computed tomography revealed a left-side pneumothorax and pleural effusion. Chest tube was inserted for drainage and the fluid was formed to contain food residuum. Contrast radiography demonstrated escape of soluble contrast medium into the left pleural space. A thoracotomy and transdiaphragmatic revealed a gastropleural fistula. It was repaired and the gastric origin was resected. Pathologic evaluation revealed evidence of chronic peptic ulceration, but no malignant change. Gastropleural fistula due to peptic ulcer without esophageal herniation, malignancy, or traumatic injury is extremely unusual. The cause of the focal adhesion of the gastric ulcer and diaphragm, fistula formation was not certain but was probably related to the ingestion of NSAIDs in combination with prednisolone and other immunosuppressive agents. Although gastropleural fistula is rare, the prognosis in such patients related to early diagnosis and surgical intervention, emphasizing the importance of including this condition when making a differential diagnosis.
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PMID:[Gastropleural fistula due to perforated gastric ulcer]. 1703 5

Esophagopericardial fistula is a rare and severe complication, involving several benign, malignant and traumatic pathologies of the esophagus. Only few cases of esophagopericardial fistula have been published so far, as compared to more frequently reported cases of gastropericardial fistula. We report on a 25-year-old female with an esophagopericardial fistula following retrosternal esophagogastroplasty for esophageal caustic stenosis. One month before admission to our hospital, the patient had fever and nonradiating substernal chest pain which was relieved by aspirin, unfortunately without adequate antacid therapy. After 3 weeks, for abdominal pain and worsening chest pain with shock, she was admitted to another hospital and underwent laparotomy: an haemoperitoneum was found, due to a rupture of an ovarian cyst which was removed. For persistent shock, the patient had an echocardiogram which revealed a cardiac tamponade, treated with placement of a pericardic drainage (300 cc of purulent liquid). She was then transferred to our unit: an esophageal swallow with a small amount of methilene blue revealed a fistula between the stomach of the esophagogatroplasty and the pericardium. She eventually underwent surgery. A pericardial window was created, the gastric tube was taken down because of the impossibility to suture the gastric ulcer, and an esophagocoloplasty was used for the reconstruction of the alimentary transit. The postoperative course was unevenqf&l. She is alive and well at 15 months after surgery. Esophagopericardial fistula is a rare complication, with a high mortality rate. A timely decision is mandatory and an aggressive treatment often necessary.
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PMID:[Treatment of esophagopericardial fistula following esophagogastroplasty for esophageal caustic stenosis]. 1772 1

A 49-year-old man presented with chest pain and was given a diagnosis of aortic dissection based on computed tomography (CT) findings. Two days later the dissection reached the origin of the celiac artery and there was poor blood flow from the body to the tail of the pancreas and fundus of the stomach wall. Severe acute pancreatitis developed. Endoscopy showed a near-circumferential gastric ulcer in the gastric cardia and we diagnosed ischemic gastropathy. A fistula between the area of infected pancreatic necrosis and the stomach had formed spontaneously and the necrotic tissue was draining into the stomach. His recovery was uneventful.
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PMID:A case of severe acute pancreatitis and ischemic gastropathy caused by acute aortic dissection. 2121 1


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