GASTRIC ULCER OF THE PYLORUS SIMULATING. HYPERTROPHIC PYLORIC STENOSIS

PEDIATRICS ◽  
1950 ◽  
Vol 6 (6) ◽  
pp. 897-907
Author(s):  
ARTHUR R. C. COLE

A brief review of the natural history of peptic ulcer in infancy and childhood is given. The symptomatology, differential diagnosis and diagnostic procedures are presented. The diagnosis of peptic ulcer should be considered more often in infancy and childhood and the proper diagnostic procedures instituted. A case of gastric ulcer simulating hypertrophic pyloric stenosis is presented. A summary of 31 cases with peptic ulcers found at autopsy at the Babies Hospital from January 1, 1924 to January 1, 1950 is given. From a summary of coexistent disease found in the autopsy cases at the Babies Hospital and reports from the recent literature, it would appear that diseases of the central nervous, gastrointestinal and respiratory systems are commonly present in cases which have shown peptic ulcer at autopsy.

Author(s):  
Pallavi. B ◽  
Sunil. N ◽  
Syed Mansoor Ahamed ◽  
Nandheesh R.

Background: A peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine. Ulcer can be developed inside the inner lining of the stomach (gastric ulcer) or the small intestine (duodenal ulcer). Peptic ulcers are usually aggravated by an imbalance between destructive and defensive factors in the stomach, it affects nearly 10% of world population. The objective of the study was to investigate the protective effect of ethanolic extract of Sesbania grandiflora Linn. Seeds (SGEE) on peptic ulcer induced by ethanol in experimental rats. Objectives: Gastroprotective effect of Sesbania grandiflora Linn. Seeds extract on experimental Materials and Methods: The gastroprotective effect of SGEE was studied using ethanol (70% ) induced acute gastric ulcer models. The animals were divided into five groups, each group contains six animals. SGEE was administered in two doses, (200 mg/kg and 400 mg/kg, p.o). The parameters investigated include acid volume, pH, total acidity, ulcer index, total protein, glutathione, lipid peroxidase, catalase & histopathological studies. Results: 1. In gastroprotective effect study, SGEE significantly inhibited the development of ulcers induced by ethanol. The SGEE significantly reduced the acid volume, total acidity, total acidity, ulcer index, lipid peroxidation & increases in pH, glutathione & catalase level. Histopathogical studies also revealed that SGEE is gastro-protective. Ranitidine (100 mg/kg) is used as standard drug. Conclusion: All the observation implies that SGEE possess significant protective activity against ethanol induced gastric ulcer in experimental rats. 400 mg/kg doses has shown more protection compared to 200 mg/kg (dose dependent activity was obtained). Keywords: Antiulcer; Sesbania grandiflora; Ethanol; Ranitidine.


Author(s):  
Tomoari Kamada ◽  
Kiichi Satoh ◽  
Toshiyuki Itoh ◽  
Masanori Ito ◽  
Junichi Iwamoto ◽  
...  

AbstractThe Japanese Society of Gastroenterology (JSGE) revised the third edition of evidence-based clinical practice guidelines for peptic ulcer disease in 2020 and created an English version. The revised guidelines consist of nine items: epidemiology, hemorrhagic gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcers, non-H. pylori, and nonsteroidal anti-inflammatory drug (NSAID) ulcers, remnant gastric ulcers, surgical treatment, and conservative therapy for perforation and stenosis. Therapeutic algorithms for the treatment of peptic ulcers differ based on ulcer complications. In patients with NSAID-induced ulcers, NSAIDs are discontinued and anti-ulcer therapy is administered. If NSAIDs cannot be discontinued, the ulcer is treated with proton pump inhibitors (PPIs). Vonoprazan (VPZ) with antibiotics is recommended as the first-line treatment for H. pylori eradication, and PPIs or VPZ with antibiotics is recommended as a second-line therapy. Patients who do not use NSAIDs and are H. pylori negative are considered to have idiopathic peptic ulcers. Algorithms for the prevention of NSAID- and low-dose aspirin (LDA)-related ulcers are presented in this guideline. These algorithms differ based on the concomitant use of LDA or NSAIDs and ulcer history or hemorrhagic ulcer history. In patients with a history of ulcers receiving NSAID therapy, PPIs with or without celecoxib are recommended and the administration of VPZ is suggested for the prevention of ulcer recurrence. In patients with a history of ulcers receiving LDA therapy, PPIs or VPZ are recommended and the administration of a histamine 2-receptor antagonist is suggested for the prevention of ulcer recurrence.


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3312
Author(s):  
Felipe Leonardo Fagundes ◽  
Quélita Cristina Pereira ◽  
Melina Luzzi Zarricueta ◽  
Raquel de Cássia dos Santos

Peptic ulcer episodes cause damage to the stomach and intestine, with inflammatory cell infiltration and oxidative stress as the main players. In this study, we investigated the potential of anthocyanidin malvidin for preventive and curative peptic ulcer treatment. The anthocyanidin effects were examined in gastric ulcer mouse models induced by ethanol, non-steroidal anti-inflammatory drugs (NSAIDs), ischemia-reperfusion (IR), acetic acid and duodenal ulcer induced by polypharmacy. Expression levels of oxidative and inflammatory genes were measured to investigate the mechanism of anthocyanin activity. At a dose of 5 mg·kg−1, Malvidin prevented gastric ulcer induction by ethanol, NSAID and repaired the tissue after 6 days of IR. Moreover, the anthocyanidin accelerated the healing of acetic acid-induced ulcer, increased the gene expression of EGF and COX-1, and downregulated MMP-9. Anthocyanin treatment mitigated the effect of polypharmacy on inflammation and oxidative stress observed in the intestine. Additionally, the compound downregulated cytokine expression and TLR4 and upregulated HMOX-1 and IL-10, exhibiting protective activity in the mouse gut. Malvidin thus prevented gastric and duodenal ulcers due to prominent anti-inflammatory and antioxidative effects on the gastrointestinal tract that were related to gene expression modulation and an increase in endogenous defense mechanisms.


2021 ◽  
Vol 51 (3) ◽  
Author(s):  
Guillermo Rubén Fernandez ◽  
Matías Zanetti ◽  
Mariano Rubén Argüello ◽  
Liria Salomé Martínez Rejtman ◽  
Marisa Francisco ◽  
...  

Giant peptic ulcers are defined as having a diameter greater than 2 cm in the case of duodenal ulcers, and greater than 3 cm in the case of gastric ulcers. The presentation is infrequent, but raises questions about the etiological factor and the definitive treatment. The literature on its physio-pathology is scarce and the cases described are unusual. The following case is presented to review the conduct to be followed in the presence of a giant gastric ulcer. We highlight the difficulty to assess the differential diagnosis of malignant pathology, trying to emphasize the value of the predictive factors of malignancy to define the conduct to follow. Finally, we focus on the relationship between the clinical presentation of gastric giant ulcer with primary gastric lymphomas and their clinical characteristics.


2016 ◽  
Vol 44 (1) ◽  
pp. 5
Author(s):  
Thalita Priscilla Peres Seabra Da Cruz ◽  
Thaís Ruiz ◽  
Wilma Neres da Silva Campos ◽  
Ludmila Silva Azevedo ◽  
Guilherme De Andrade Bicudo ◽  
...  

Background: One of the causes of delay gastric emptying is the chronic hypertrophic pyloric gastropathy, unusual disease that can occur in acquired or congenital form. It is characterized by hypertrophy of the antral mucosa, by thickening of the muscular layer, or by hyperplasia of the pylorus. The animals are presented with a history of chronic intermittent vomiting. Treatment is based on surgical correction through techniques such as pyloromyotomy or transverse or Y-U pyloroplasty. Thus, the aim was report three cases of pyloric stenosis by hypertrophy in dogs of the breeds, Fila Brasileiro, English Bull Terrier and American Pitbull Terrier, emphasizing the diagnosis and therapy instituted.Cases: All animals in this study reached the Veterinary Hospital of the Federal University of Mato Grosso with a history of chronic intermittent vomiting. The findings of physical and laboratory examinations in all animals were unspecific, with those important to rule out other causes of vomiting. Contrast radiographic evaluation revealed marked stomach distension and delayed gastric emptying, indicated gastric outflow obstruction. In one case, a video endoscopy was performed. The images reveal hyperemia of the gastric mucosa with small areas of bleeding around the stomach. It was observed intense production of gastric juice and the presence of the same reflux. In the pyloric antrum, a thick fold reddish gastric mucosa, which partially obstructed the pyloric ostium. There was very little motility during the examination. As therapeutic approach for all cases, we opted for performing the surgical technique of pyloroplasty in Y-U, consisting of enlarging the diameter of the antral pyloric region in an attempt to create a broader pylorus, what make possible an emptying a gastric rapidly. All the pacients remained in hospital in the postoperative period receiving medications intravenously. Postoperative fluid based on Ringer’s lactate solution and administration of ondansetron (0.2 mg/kg every 8 h), sucralfate (30 mg/ kg every 12 h), sulfadoxine to trimethoprim (20 mg/kg every 12 h) and meloxicam (0.2 mg/kg every 24 h). Twelve h of fasting after the surgical procedure without vomiting, the dog received light past food. An average of three to four days post-surgical discharged with recommendations to keep antibiotic therapy for ten days and light diet. The fifteenth day of surgery, the patients returned for removal of skin spots, with good general condition and satisfactory healing. No cases of vomiting were reported. As the case one returned to perform the monitoring gastograma. The dog was anesthetized and giving the contrast. On radiographs, there was a slight delay in gastric emptying, which can be explained by the anesthesia used for contrast administration, as described in the literature. The images showed stomach and intestines in size, shape and normal position. The technique was satisfactory in reducing clinical signs in all these cases, confirmed by the absence of vomiting in the post-operative period.Discussion: The surgical technique used, pyloroplasty Y-U consists of traspor a part of the antral wall to the pyloric region in an attempt to create a broader pylorus, and possibly a time soon gastric emptying. It was possible to demonstrate with only three cases the pyloroplasty Y-U proved to be a simple and effective technique for the treatment of hypertrophic pyloric stenosis with a favorable prognosis in all cases. Thus, disease should be considered in the differential diagnosis in cases of gastric outflow obstruction, regardless of patients age.Keywords: dog, hypertrophy, pylorus.


1993 ◽  
Vol 27 (1) ◽  
pp. 42-43 ◽  
Author(s):  
Lynn L. Estes ◽  
David W. Fuhs ◽  
Alan H. Heaton ◽  
Conrad S. Butwinick

OBJECTIVE: To report a case of a perforated gastric ulcer associated with the use of injectable ketorolac tromethamine. DATA SYNTHESIS: A 77-year-old woman with no previous history of peptic ulcer disease developed a perforated gastric ulcer after four days of treatment with ketorolac. To date, six other cases of gastrointestinal (GI) perforation associated with the use of ketorolac have been reported to the manufacturer. CONCLUSIONS: Although ketorolac is an effective analgesic, it is a nonsteroidal antiinflammatory agent and thus has the propensity for causing GI ulceration. Caution should be used when administering this drug and patients should be monitored for GI adverse effects.


2013 ◽  
Vol 79 (9) ◽  
pp. 896-896
Author(s):  
Stephanie M. Streit ◽  
Jennifer A Dixon ◽  
André Hebra

Hypertrophic pyloric stenosis is a very common surgical problem in infants. It occurs most often in otherwise well babies with normal gestation and birth history. Rarely, pyloric stenosis has been described in babies with history of prior abdominal surgery. Below we discuss the management of hypertrophic pyloric stenosis in a child who remained hospitalized, recovering from repair of a congenital abdominal wall defect.


2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Yves Alain Notue ◽  
Ulrich Igor Mbessoh ◽  
Tim Fabrice Tientcheu ◽  
Boniface Moifo ◽  
Alain Chichom Mefire

Abstract Gastric outlet obstruction encompasses a broad spectrum of conditions characterized by complete or incomplete obstruction of the distal stomach, which interrupts gastric emptying and prevents the passage of gastric contents beyond the proximal duodenum. Idiopathic hypertrophic pyloric stenosis is the most common cause with an incidence of 1.5–3 per 1000 live births. However, it is excluded; other causes in children such as peptic ulcer disease are relatively rare. We report a case of an acquired gastric outlet obstruction due to peptic ulcer disease, previously misdiagnosed as idiopathic hypertrophic pyloric stenosis in a 16-year-old girl. Beyond the rarity of this clinical event, this case highlights the challenges of the aetiological diagnosis of gastric outlet obstruction with subsequent therapeutic issues, and is the first documented case in Cameroon.


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