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

Gastric juice from 15 normals, 20 patients with gastric ulcer and 14 patients with erosive haemorrhagic gastroduodenitis was investigated in respect of its activity on unheated and heated fibrin plates and its content of FDP and plasminogen or plasmin with immunochemical methods. Gastric juice from normals showed no activity on unheated and heated fibrin plates, and no FDP or plasminogen could be demonstrated. In the patients with gastric ulcer the gastric juice showed little or no fibrinolytic activity on fibrin plates except in 2, who had regurgitation of duodenal juice and neutral pH of the juice. These patients had equally high activity on heated as on unheated plates and no plasmin could be demonstrated. It was shown that this activity was not due to fibrinolysis, but to non-specific proteolytic activity (probably trypsin). The patients with erosive haemorrhage gastroduodenitis exhibited quite a different picture. The gastric juice from these patients showed extremely high activity on fibrin plates, the activity was higher on unheated than on heated plates. The activity was inhibited in vitro by addition of EACA and in vivo after administration of AMCA. The occurence of plasmic could be demonstrated directly immunologically in the gastric juice. By comparsion of plasmin and trypsin in various assays it could further be improved that the gastric juice in these cases contained plasminogen activator and plasmin. The patients with erosive haemorrhagic gastroduodenitis showed no increase in fibrinolysis in the blood, but low values for plasminogen and alpha2-M, and the serum contained FDP. These findings in the blood and gastric juice were interpreted as signs of local fibrinolysis in the stomach and duodenum. There is reason to assume that this gastric fibrinolysis contributes substantially to the bleeding tendency. The effect of administration of AMCA on fibrinolytic activity and the haemorrhage lends support to the assumption of such a mechanism.
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PMID:Gastric fibrinolysis. 0 Aug 7

Employing 99m Tc-colloid and external scanning, a test has been developed to measure duodeno-gastric regurgitation quantitatively. The test is relatively simple and its reproducibility is good. Thirty-two patients with type I gastric ulcer had a median reflux of 14%, significantly higher than nine controls and nine duodenal ulcer patients with a median reflux of 4% and 5%, respectively.
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PMID:Quantitative determination of pyloric regurgitation in response to intraduodenal bolus injection. 59 53

Regurgitation of bile into the stomach after gastric surgery often causes severe and distressing symptoms, though the onset may be delayed for some years. We have used a Roux loop diversion as a secondary procedure for bile reflux in 36 patients, making the anastomosis from 18 to 40 cm below the stomach. There were no deaths and the clinical results were good in 20 of 27 patients followed up from 1 to 10 years. Vagotomy was omitted in 13 patients, 2 of whom subsequently developed jejunal ulceration. One patient developed an unexplained gastric ulcer and 2 operations failed because the loop was too short. The optimum length may well be 40 cm and vagotomy should be added in all cases. In 3 patients with associated dumping the upper 10 cm of the Roux loop was reversed.
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PMID:Roux diversion for bile reflux following gastric surgery. 64 97

Duodenogastric reflux is a pathophysiological phenomen occurring after motility disturbances on the antroduodenal junction and after operative procedures destroying, removing or bypassing the pylorus. The reflux of bile can lead to a symptomatic chronicatrophic gastritis and is an important factor in the pathogenesis of gastric ulcer type I. The pyloric regurgitation test, marking of the bile with Bromsulphalein or 14C-chenodesoxycholic acid are reliable methods to prove reflux. For treatment of bile reflux and postoperative alkaline reflux gastritis substances augmenting antral peristalsis and binding bile acids can be used. More effective are surgical procedures diverting the bile flow from the stomach or the gastric remnant.
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PMID:[Duodenogastric reflux]. 87 Oct 59

In a series of 48 patients with dyspepsia but without gastric ulcer it is shown that pyloric regurgitation occurred significantly more often in patients with distal and combined anomalies of the duodenum or a short loop than in patients with a normal duodenal loop. No difference existed between patients with proximal duodenal anomalies and the normal group. When pyloric regurgitation occurred in the erect position it could be prevented in the supine position and also to some extent by intravenous by intravenous administration of 20 mg metochlopramide.
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PMID:Abnormal duodenal loop and pyloric regurgitation. 92 Feb 38

This is the report of the presence of a benign gastric ulcer in a patient with achlorhydria and documented pernicious anemia. The pernicious anemia was established by a Histalog-fast achlorhydria, a Schilling test of 2.1% excretion of tagges vitamin B12 in a 24-hr urine, and reticulocytosis after administration of cyanocobalamine. Following Histalog (1.5 mg per kg of body weight), the gastric volume was 40 ml, there was no acid, and the pH was 8.1. The ulcer demonstrated by gastroscopy was confirmed at gastrectomy. Histological examination of the ulcer and the remainder of the stomach showed no malignancy. The principal conclusion of this paper is that the patient did not have an acid-produced ulcer, but that bile regurgitation coupled with alcohol ingestion produced the lesion. Surgical investigation of the ulcer seemed mandatory because of the known increased incidence of gastric carcinoma in patients with pernicious anemia.
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PMID:Benign gastric ulcer in a patient with pernicious anemia. 115 91

Of 957 patients undergoing operation for benign gastric ulcer and its complications from 1965 through June 1975, 90 had perforated ulcers. Among these were four patients in whom a gastrocolic fistula had formed. Although two of the four patients had symptoms due to peptic ulcer dating back 12 and 68 months, symptoms of a gastrocolic fistula were the initial presentation of ulcer disease in the other two. All four patients had watery diarrhea and weight loss, and barium enema examination was diagnostic in each case. The perforating ulcers were located in the distal stomach on the greater curvature in all four patients. Although enterostasis was not present in these cases, regurgitation of colonic contents probably results in bacterial overgrowth in the small intestine, causing structural and functional damage to the mucosal cells by bacterial products, manifested clinically by diarrhea in 75% of the patients. Surgery should be advised in all cases after adequate preparation of the patient; bowel preparation with cathartics, enemas, and oral antibiotics is mandatory. The preferred operation is one-stage enbloc hemigastrectomy and resection of the involved segment of colon along with the fistulous tract. The present series brings to 43 the total number of cases of gastrocolic fistulas complicating benign, previously unoperated gastric or duodenal ulcers. There is an appreciable mortality associated with this condition - 7 of these 43 patients (16%) died as a direct consequence of their fistula.
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PMID:Gastrocolic fistula complicating benign unoperated gastric ulcer. Report of four cases and review of the literature. 126 93

Between 1974 and 1984, 1,188 patients with esophageal malignancies were treated in the Division of Thoracic Surgery of Veterans General Hospital, Taipei. The rate of resectability was 42.6%. Since 1974, the stomach has been used as esophageal substitute, and through 1984, a total of 368 patients were collected. The routes of reconstruction included retrosternal (77.2%), posteromediastinal (7.1%), and intrathoracic (15.7%). The rates of postoperative complications and surgical mortality in these 368 patients were 26.3% and 6.5%, respectively. Leakage of anastomosis was the most frequent complication. The incidence of stricture of esophagogastrostomy was 25.5%. All strictures were relieved by esophageal dilations. An average of 3.9 esophageal dilations were performed per patient (range, 1 to 15). Radical lymph node dissection was not routinely performed in our series. The actuarial 2-year and 5-year survival rates were 26.4% and 7.6%, respectively. Among 76 patients undergoing cervical esophagogastrostomy and surviving for more than 1 year, late complications occurred as follows: acid/bile regurgitation, 46.1%; postprandial fullness of abdomen, 38.2%; dumping syndrome, 13.2%; distended stomach with dyspnea, 11.8%; aspiration pneumonia, 6.6%; and gastric ulcer, 6.6%. Moreover, compared with patients without pyloroplasty, those with pyloroplasty were found to have a higher incidence of bile regurgitation (55.5% versus 8.6%), dumping syndrome (33.3% versus 6.9%), aspiration pneumonia (16.7% versus 3.4%), and gastric ulcer (22.2% versus 1.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gastric substitution for resectable carcinoma of the esophagus: an analysis of 368 cases. 173 71

Complex study of the frequency and intensity of the duodenogastric reflux in 468 patients with peptic ulcer is analysed; 372 had duodenal ulcer and 96 had gastric ulcer. The authors give the characteristics of the diagnostic possibilities of X-ray, endoscopic, ionomanometric, and aspiration (radionuclide and biochemical) methods of examination of duodenal regurgitation. They proved the relation of the frequency and intensity of the duodenal regurgitation to the type of the ulcer and the phase of its course (exacerbation or remission), the condition of the pyloric closure function, and disorders of duodenal motor activity. The sequelae of long-term duodenogastric reflux are analysed; it is shown that patients must be examined in the preoperative period in the phase of remission so as to gain the true values of intensity of the reflux for its subsequent correction.
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PMID:[Duodenogastric reflux in patients with peptic ulcer]. 235 39

We have established an experimental model of chronic gastric ulcer, in rats which transection of the lower horizontal portion of the duodenum and anastomosis of the forestomach to the upper part of the jejunum caused regurgitation of all duodenal juice into the stomach. After 3, 6, 12, and 30 wk, all treated rats developed an ulcer in the prepyloric region on the lesser curvature of the stomach. More than half of the antrum was finally involved in the ulcer. Histologic studies revealed chronic ulcers quite similar to human ones. As a control series, transection at the pylorus failed to produce an ulcer. Although many papers have appeared regarding the experimental production of chronic gastric ulcer, most of the studies reported have applied chemicals, drugs, or mechanical injury to the gastric mucosa. Our model produced chronic regurgitation of duodenal juice as a natural phenomenon, and uniformly resulted in ulcer formation. Intragastric total bile acid concentrations were significantly elevated in the reflux group. Serum gastrin levels, the thickness of the fundic mucosa, and the height of fundic gland were also significantly increased. Thus, the detergent action of bile acids and the increased acid secretion were assumed to play an important role in ulcer formation. Further studies using this model are warranted on the pathogenesis of chronic peptic ulceration.
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PMID:A new model for production of chronic gastric ulcer by duodenogastric reflux in rats. 356 68


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