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

A 72-year-old woman who had been given heavy premedication nonetheless developed severe retching at the beginning of a gastroscopy (for suspected gastric ulcer) when the instrument had been advanced only as far as the throat. The investigation was at once terminated, but barium swallow immediately afterwards revealed rupture at the middle third of the oesophagus, with contrast medium flowing into the mediastinum. Despite emergency thoracotomy and suturing of a 4 cm long fresh oesophageal tear in the area of a diverticulum, the patient died from a purulent mediastinitis and confluent pneumonia. The cause of this "spontaneous" rupture of the oesophagus without direct transmission of force (Boerhaave syndrome) in this case was a marked pressure increase in the oesophagus from retching and hyperperistalsis preparatory to gastroscopy. There had definitely not been any instrumental perforation. There was thus no medical negligence.
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PMID:[An unusual case of Boerhave syndrome. Esophageal rupture during preparation for gastroscopy]. 392 25

A total of 156 double contrast barium examinations were independently interpreted by two observers for the presence of gastric ulcer. The observed agreement between the two readings was 93 per cent, and after adjusting for the expected chance agreement a kappa value of 0.73 was obtained. At the first reading 4 ulcers, and at the second reading 8 ulcers were interpreted as malignant. None of these interpretations agreed. In a questionnaire study it was demonstrated that gastroenterologists had a realistic impression of the level of agreement in the radiographic detection of gastric ulcer.
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PMID:Interobserver variation in the radiographic diagnosis of gastric ulcer. Gastroenterologists' guesses as to level of interobserver variation. 401 17

A prospective study was made of 817 consecutive episodes of major gastrointestinal haemorrhage in patients admitted to hospital during 1967-8 from the defined population of North-East Scotland. The yearly admission rate was 116 per 100,000 population. Comparison of the data for city and country residents showed no appreciable differences. In the duodenal ulcer group there was an undue incidence of bleeding among foremen and skilled workers and among those who were unmarried or widowed.Both the clinical history and the results of any previous barium meal examinations were unreliable guides to the source of the current haemorrhage. Prognosis was worse for patients who did not have a dyspeptic history and was better for those who had bled on a previous occasion. The simultaneous ingestion of alcohol and aspirin had an adverse effect on the occurrence of bleeding. Forty-seven per cent. of the patients had another major coincidental disease.Mortality was 13.7% in the whole series and 8.6% in those with peptic ulcer (duodenal ulcer 7.1%, gastric ulcer 16.9%). In 28% of the patients further haemorrhage occurred after admission to hospital and caused a 28.8% mortality. Seventy-four patients were already in hospital when they first bled and 44% of them died.
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PMID:Epidemiology and course of gastrointestinal haemorrhage in North-east Scotland. 454 62

Of 19 patients with chronic non-specific lung disease, chosen without reference to dyspeptic symptoms, 17 (89%) exhibited duodenogastric reflux of barium indicating pyloric incompetence. In the one patient who proved to have a gastric ulcer the amount of reflux diminished when the ulcer healed. The degree of pyloric incompetence was not found to be related to the severity of arterial blood gas or pH disturbance or to the presence of right heart failure. All patients who exhibited reflux had evidence of obstructive airways disease and most were receiving bronchodilators.We believe that reflux of detergent bile into the stomach may explain the high incidence of dyspepsia and acute gastric ulceration in chronic non-specific lung disease.
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PMID:Pyloric incompetence in chronic non-specific lung disease. 554 53

The results of 2500 upper gastrointestinal fibreoptic endoscopies carried out at Soba University Hospital, Khartoum, between January, 1980, and June, 1982, were reviewed. 42% of the patients had no disorder visible on endoscopy, 9% had oesophageal varices, 0.7% gastric ulcer, 17% duodenal ulcer, and 2% pyloric obstruction. Duodenal ulcer was seen more commonly in men (male/female ratio 4.5/1) and in young people. Endoscopy is a feasible procedure in developing countries. It is more informative and cheaper than barium meal radiology.
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PMID:Upper gastrointestinal fibreoptic endoscopy experience in the Sudan. Analysis of 2500 endoscopies. 613 9

The aim of the study was to determine the effectiveness of cimetidine in a dose of 400 mg twice daily in the prevention of gastric ulcer recurrence over a 2-yr period. The trial was double-blind and placebo-controlled; 24 patients received cimetidine and 25 received placebo. All had had a gastric ulcer within the prior 6 wk, and healing was demonstrated by endoscopy or by barium meal. The patients were contacted at monthly intervals, and if symptoms were present, investigations were performed. Annual barium meal examinations or endoscopy were also performed in all except 7 patients. In the placebo group, there was rapid recurrence within the first 12 mo; 12 of the 13 recurrences that occurred in this group over the 2-yr period took place within the first 12 mo. In the cimetidine-treated group, there were eight recurrences over the 2-yr period, five of which occurred in the first year. Log rank comparison showed a significant benefit due to cimetidine at 1 yr, but not over the 2-yr period.
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PMID:A two-year prospective controlled study of maintenance cimetidine and gastric ulcer. 634 75

Seventy-five dialysis patients awaiting renal transplantation were studied. Investigations included single contrast barium meal, serum gastrin assay, gastric acid studies, and fiberoptic gastroduodenoscopy with multiple biopsies. Radiological studies revealed five duodenal ulcers and one gastric ulcer. Endoscopy showed gastroduodenal lesions in 57 patients (49%). Superficial gastritis was present in 50 patients (66.7%), atrophic gastritis in 11 (14.6%), and duodenitis in 30 (40%). Hypergastrinemia was observed in 48 patients (64%). Maximum acid output was markedly elevated in 33 patients. Acid hypersecretion was found to be correlated with the presence of endoscopic lesions and histological evidence of gastritis. Nine of the 11 patients with atrophic gastritis were acid hyposecretors and had low gastrin levels. Pretransplant gastric assessment identified a relevant number of gastroduodenal lesions in these patients. The increased risk of severe posttransplant ulceration justifies thorough gastric assessment and prophylactic antiulcer therapy in all renal transplant candidates.
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PMID:Assessment of the upper gastrointestinal tract in hemodialysis patients awaiting renal transplantation. 634 17

A review of 7,600 double-contrast barium-meal studies performed between 1975 and 1981 revealed 221 gastric ulcers reported as benign. The follow-up for 199 of these was adequate and detected no case of carcinoma. The widespread practice of immediate endoscopy and biopsy for all cases of radiologically benign gastric ulcer represents a misuse of expensive medical resources. When a gastric ulcer is demonstrated clearly as benign on double-contrast examination, there is no need for endoscopic confirmation of the diagnosis.
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PMID:Benign gastric ulcer: a reliable radiologic diagnosis? 660 29

On occasion gastric ulcers may be recognized on plain abdominal radiographs. A case in which a gastric ulcer was diagnosed on the plain abdominal radiograph, illustrating the importance of careful scrutiny of the plain film in all cases of acute abdomen, is presented. The existence of the lesser curvature ulcer was confirmed on barium contrast studies.
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PMID:Gastric ulcer diagnosed on a plain abdominal radiograph. 683 30

Upper gastrointestinal fibreoptic endoscopy, performed on 1,084 Ethiopians, revealed: 48 (4%) oesophageal varices, 16 (1%) oesophageal carcinoma, 394 (36%) chronic atrophic gastritis, 36 (3%) gastric carcinoma and 154 (14%) duodenal ulcer. Oesophagitis, gastric ulcer and stomach ulcer are rare. The high prevalence of oesophageal varices and the association of chronic atrophic gastritis with gastric carcinoma are noted. There is a poor correlation between barium meal and endoscopic findings mainly because of inadequate radiological services in the country. All 16 patients who had endoscopy within 48 hours of haematemesis and/or melena had the source of bleeding identified. In a country like Ethiopia where upper gastrointestinal symptoms are very common and radiological services inadequate, expert endoscopic studies can be of great diagnostic value.
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PMID:Analysis of fibreoptic gastroduodenoscopy in 1084 Ethiopians. 697 21


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