Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since 1993, 272 patients underwent surgery on gastrointestinal tract: 92--for gastric ulcer, 79--for duodenal ulcer, 29--for cancer of the stomach, 67--for cancer of the colon, 5--for other diseases. The main operations were resection of the stomach (195), hemicolectomy (23), abdominal-anal and anterior resection of the rectum (44). In 135 patients group 1 all stages of surgery on gastrointestinal tract were performed with "Auto Suture" instruments (USA). In 137 patients group 2 anastomosis was created by two-layer nodal suture with Russian auto-suture instruments (UKL-60, UO-40) during some stages of operation. Postoperative complications occurred in 57 (20.9%) patients: 14 (5.1%) in group 1 and 43 (15.8%) in group 2. Predominant complications were suppuration of the wound (7 and 14 cases, respectively), anastomositis (2 and 10), pneumonia (8--only in group 2), bleeding in anastomotic zone (5--only in group 2). After surgery 7 (2.6%) patients died due to causes not associated with method of surgery or anastomosis creation. Advantages of modern auto-suture instruments in surgery of gastrointestinal tract are demonstrated: reduction of surgery time, simplicity and reliability of anastomosis creation, possibility of use in hard to reach abdominal parts (low anterior resection of the rectum), better postoperative period, a 3-fold decrease of postoperative complications number.
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PMID:[Use of present-day suturing instruments in gastrointestinal surgery]. 1152 2

Malignant melanoma involving the gastrointestinal tract is diagnosed antemortem in only a small percentage of patients with the disease. Presenting symptoms are often non-specific, causing a diagnostic problem. The vast majority of such melanomas are metastatic from a cutaneous primary, however there is evidence that the tumour can arise de novo in the gastrointestinal system. We report a 74-year-old man with malignant melanoma with an unusual presentation simulating a symptomatic gastric ulcer. He presented with epigastric pain, haematemesis and melaena. Explorative laparotomy revealed a large ulcerated tumour with several pigmented satellite nodules in the proximal stomach, multiple ileal nodules and widespread nodal and liver metastases. Proximal gastrectomy and limited small bowel resection was performed. Histology revealed the tumour to be composed of nests of epithelioid cells with melanin pigment. The tumour cells showed immunohistochemical positivity for S100 protein and HMB45 antibodies. This report emphasizes that melanoma should be a diagnostic consideration in patients with gastric ulcer.
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PMID:Malignant melanoma of the gastrointestinal tract presenting as a bleeding gastric ulcer. 1619 79

Here, we report on two patients with hemorrhagic shock due to hematemesis from a gastrointestinal stromal tumor (GIST) of the stomach. Patient 1 was a 64-year-old woman who was admitted to our hospital because of syncope due to hemorrhagic shock resulting from massive hematemesis. Emergent upper gastrointestinal (GI) endoscopy revealed a 5-cm-diameter submucosal tumor on the lesser curvature of the lower gastric body. In addition to the central ulceration of the tumor, a Dieulafoy-like lesion was present. Neither lesions showed active bleeding at the time of observation. Because the patient collapsed twice with fluminant hematemesis after admission, she underwent distal gastrectomy with Billroth-I reconstruction. Histological examination revealed a gastric GIST with no nodal metastasis and the mitotic count was less than 5 per 50 HPFs. Dilated vessels were prominent in the peritumoral submucosa, and a thrombus was seen in these vessels, which seemed to be a bleeding point. The patient had an uneventful postoperative course and has been alive without recurrence for 5 and a half years. Patient 2 was a 60-year-old man who presented with syncope due to hemorrhagic shock resulting from massive hematemesis. Because the source of the bleeding was not elucidated with an initial upper GI endoscopy, he was treated for a gastric ulcer. One week after admission, he suffered from hemorrhagic shock again, and a submucosal tumor 6 cm in size was revealed on the greater curvature of the upper stomach with upper GI endoscopy. The patient subsequently underwent wedge resection of the tumor. Histopathological findings were consistent with a GIST and the mitotic count was less than 5 per 50 high-power fields. The tumor showed no necrosis or intratumoral hemorrhage. A peritumoral submucosal artery, which was responsible for the massive hematemesis, was located at some distance away from the central ulceration. Postoperative recovery was without complications. After 4 years, the patient remains healthy and disease-free. Although hematemesis associated with gastric GIST has been said to originated from the central ulceration of the GIST, life-threatening, massive hematemesis is rare. The exact bleeding points of the gastric GISTs in these cases were submucosal vessels adjacent to the GIST, not the central ulceration. There have been no reports of peritumoral, submucosal vessels causing massive hematemesis from gastric GISTs. Because the origins and manner of bleeding varies in gastric GISTs, we must decide the methods of hemostasis immediately including the tumor excision.
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PMID:Life-threatening bleeding from gastrointestinal stromal tumor of the stomach. 1902 73