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Journal of Feline Medicine and Surgery Oct 2022The aim of this study was to describe the endoscopic appearance of gastroduodenal ulcers (GDUs), and to assess the clinical, ultrasonographic and histological data, as...
OBJECTIVES
The aim of this study was to describe the endoscopic appearance of gastroduodenal ulcers (GDUs), and to assess the clinical, ultrasonographic and histological data, as well as long-term follow-up, in cats.
METHODS
The medical record databases of five veterinary endoscopists were evaluated between January 2016 and 2020, in a retrospective study. Cats with at least one gastric or duodenal ulcer detected by endoscopic examination were included. All the medical records of the selected cats were reviewed and information was collected regarding breed, age, sex, neuter status, medical history, clinical signs, and ultrasonographic, endoscopic and histological findings. The cats were evaluated at 6, 12 and 18 months.
RESULTS
Sixty-one cats with a median age of 9.0 years (range 2.0-16.0) were included in the study. The most common complaints were vomiting (n = 55; 90%) and hyporexia (n = 40; 66%); haematemesis was reported in 12 (20%) cats. Endoscopy showed GDUs in the following locations: gastric body in 28 cats (46%), antropyloric area in 34 cats (56%), fundus in 13 cats (21%) and duodenum in eight cats (13%). A single GDU was found in 42 cats (69%) and multiple GDUs were seen in 19 cats (31%). Histopathological evaluation revealed benign lesions in 33 (54%) cats and malignant lesions in 28 (46%; 24 high-grade lymphoma, one low-grade lymphoma and three carcinoma). High-grade lymphoma was detected only in the stomach. Cats diagnosed with malignant GDUs (median 10.5, range 4-16) were significantly older than cats with benign lesions ( = 0.002).
CONCLUSIONS AND RELEVANCE
GDUs are common and were detected in 5.1% of cats undergoing an upper gastrointestinal endoscopy. The risk of a malignant ulcer increases proportionally with each year of increasing age. GDU location, number and morphological appearance do not provide any indication of the nature of the ulcer; however, duodenal ulcers are frequently benign. Endoscopic examination facilitates the early and minimally invasive detection of GDUs in cats.
Topics: Animals; Cat Diseases; Cats; Duodenal Ulcer; Duodenum; Lymphoma, Non-Hodgkin; Retrospective Studies; Ulcer
PubMed: 35848606
DOI: 10.1177/1098612X221109802 -
Annals of the Royal College of Surgeons... Jan 2022Intestinal intussusception is uncommon in adults. As a retroperitoneal structure, gastroduodenal intussusception is extremely rare. The leading cause of intussusception...
Intestinal intussusception is uncommon in adults. As a retroperitoneal structure, gastroduodenal intussusception is extremely rare. The leading cause of intussusception is reported to be a tumour, either benign or malignant. The case presented may be the first of gastroduodenal intussusception resulting from severe peptic ulcer. A 64-year-old man was admitted with epigastralgia, appetite loss and melena for 1 week. He had history of peptic ulcer and reflux esophagitis for 9 years, caused by infection; eradication therapy had been performed 5 years previously. This time, an abdominal computed tomography scan showed duodenogastric intussusception and gastric outlet obstruction. Preoperative biopsy failed for complete obstruction; thus, the patient underwent Whipple procedure for complete resection under impression of malignancy. The postoperative course was uneventful. Pathological findings for the specimen showed gastric and duodenal ulcer. Progressive peptic ulcer after eradication therapy is rarely seen, and eradication therapy is used widely to treat infection. The eradication rate is extremely high in Taiwan for lower first-line antibiotic as clarithromycin resistance is low due to a policy restricting antimicrobial usage. Early eradication therapy is highly recommended for patients with infection. We emphasise the importance of regular follow-up for the non-significant correlation of severity of gastric ulcer with clinical symptoms. When ulceration progresses or non-invasive treatments fail early surgical interventions should be applied to these anatomic alterations.
Topics: Duodenal Ulcer; Humans; Intussusception; Male; Middle Aged; Stomach Diseases
PubMed: 34730406
DOI: 10.1308/rcsann.2021.0067 -
Gut Sep 1991To determine whether the social class differences in duodenal ulcer frequency may be explained by differences in physical activity at work, the energy expenditure during...
To determine whether the social class differences in duodenal ulcer frequency may be explained by differences in physical activity at work, the energy expenditure during work, smoking habits, and social class were compared in 76 recently diagnosed duodenal ulcer patients and in age and sex matched community controls. As anticipated, the relative risk of duodenal ulcer showed significant associations with smoking and social class. Social class and physical activity at work were associated with one another. After adjusting for age, sex, smoking, and social class, physically active work was still associated with duodenal ulcer, with relative risks for moderate and high activity compared with sedentary work being 1.3 (0.6-3.0) and 3.6 (1.3-7.8) respectively. Within each social class stratum, the relative risk of having a duodenal ulcer was greater in those with a high level of occupational activity than in those undertaking sedentary work.
Topics: Adult; Case-Control Studies; Duodenal Ulcer; Energy Metabolism; Humans; Middle Aged; Occupations; Physical Exertion; Risk Factors; Smoking; Social Class
PubMed: 1916502
DOI: 10.1136/gut.32.9.983 -
Gut Apr 1984Intraluminal duodenal pH was recorded using a combined miniature electrode and logged digitally every 10 or 20 seconds for five hours (basal/meal/drink) in eight control...
Intraluminal duodenal pH was recorded using a combined miniature electrode and logged digitally every 10 or 20 seconds for five hours (basal/meal/drink) in eight control subjects and 11 patients with duodenal ulcer (five on and off treatment with cimetidine). Over the whole test there were no significant differences in duodenal mean pH or log mean hydrogen ion activity (LMHa) between control subjects and patients with duodenal ulcer, but there were significantly longer periods of duodenal acidification (pH less than 4) and paradoxically more periods of duodenal alkalinisation (pH greater than 6) in the duodenal ulcer group compared with controls. After a meal duodenal mean pH and LMHa fell significantly in both controls and patients with duodenal ulcer, with more periods of duodenal acidification and alkalinisation in the duodenal ulcer group. An exogenous acid load (Coca-Cola) significantly increased the periods of duodenal acidification, and reduced alkalinisation, in both groups. Cimetidine significantly increased mean pH and LMHa and abolished the brief spikes of acidification in four of five patients with duodenal ulcer. Peak acid output (but not basal acid output) was significantly correlated with duodenal mean pH and LMHa but not with the periods of duodenal acidification. Smoking did not affect duodenal pH in either group.
Topics: Adult; Beverages; Carbonated Beverages; Cimetidine; Duodenal Ulcer; Duodenum; Food; Gastric Acid; Humans; Hydrogen-Ion Concentration; Intestinal Secretions; Male; Middle Aged; Smoking
PubMed: 6706217
DOI: 10.1136/gut.25.4.386 -
African Health Sciences Dec 2013Gastro-duodenal perforations are common and may complicate peptic ulcer disease. Management is often by surgical closure. (Review)
Review
BACKGROUND
Gastro-duodenal perforations are common and may complicate peptic ulcer disease. Management is often by surgical closure.
OBJECTIVE
To determine the patterns of presentation and mode of management of duodenal ulcer perforations.
METHODS
Retrospective review of patients with duodenal ulcer perforations seen at the Obafemi Awolowo University Teaching Hospital between June 2001 and July 2011. Patients' records were reviewed for demography, duration of disease, probable risk factors, type of surgery and complications. Data obtained was analyzed using SPSS 15.0.
RESULT
Forty- five patients were reviewed. There were 37 males (82.2%). Mean age was 39.7years (range 15-78years). There were 10 (22.6%) students and 8(17.8%) farmers. NSAIDs abuse (11), previous peptic ulcer disease (2), and no prior dyspeptic symptoms (20) constituted 24.4%, 4.4% and 44.4% respectively of cases. Seven (16%) patients presented less than 24 hours of onset of illness. Forty one perforations (91.1%) involved the first part of duodenum. Twenty two (49%) patients had Graham's omental patch. We had one (2.2%) failed repair and six (13.3%) mortalities.
CONCLUSION
Late presentation of duodenal ulcer perforation is common with high mortality. Pragmatic surgical intervention with Graham's omentopexy with broad spectrum antibiotics is still commonly practiced.
Topics: Adolescent; Adult; Aged; Digestive System Surgical Procedures; Disease Management; Duodenal Ulcer; Female; Hospitals, University; Humans; Male; Middle Aged; Nigeria; Peptic Ulcer Perforation; Retrospective Studies; Risk Factors; Socioeconomic Factors; Treatment Outcome
PubMed: 24940311
DOI: 10.4314/ahs.v13i4.7 -
British Medical Journal Aug 1980Two histamine H2 antagonists, cimetidine and ranitidine, given in doses of 1 g daily and 200 mg daily to 18 and 20 patients respectively proved equivalent in promoting... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
Two histamine H2 antagonists, cimetidine and ranitidine, given in doses of 1 g daily and 200 mg daily to 18 and 20 patients respectively proved equivalent in promoting healing of duodenal ulcer. No adverse effects occurred during the trial, though serum urea and creatinine concentrations tended to rise slightly during treatment with cimetidine but not ranitidine. Choice between the two drugs is likely to be influenced by overall patterns of adverse effects rather than considerations of individual potency.
Topics: Adult; Cimetidine; Clinical Trials as Topic; Creatinine; Double-Blind Method; Duodenal Ulcer; Female; Furans; Guanidines; Histamine H2 Antagonists; Humans; Male; Middle Aged; Ranitidine; Urea
PubMed: 6107154
DOI: 10.1136/bmj.281.6238.473 -
JPMA. the Journal of the Pakistan... Apr 2022A 57 years old male presented in the emergency department of EAST Surgical Ward, MAYO Hospital Lahore in February 2021 with complaints of abdominal distension, pain and...
A 57 years old male presented in the emergency department of EAST Surgical Ward, MAYO Hospital Lahore in February 2021 with complaints of abdominal distension, pain and vomiting. He was a chronic smoker and diagnosed hypertensive for the last 14 years but was non-compliant with oral antihypertensive medications. He was a factory worker and took NSAIDs off and on for pain in the knee joint for the last five years. On examination, his abdomen was tense and tender with resonant percussion notes in the right hypogastrium and epigastrium. His chest x-ray showed free gas under the right diaphragm. Diagnosis of a perforated duodenal ulcer was made and exploratory laparotomy was done. Examination revealed a perforated ulcer in the first part of the duodenum with greenish gangrenous patches on the next 3 feet of the small gut. Graham's patch repair and resection of the diseased small gut was done and a jejuno ileostomy was performed. Unfortunately, the patient expired on 2nd postoperative day due to sudden cardiopulmonary arrest.
Topics: Abdominal Pain; Duodenal Ulcer; Humans; Male; Mesenteric Ischemia; Middle Aged; Peptic Ulcer Perforation; Tertiary Care Centers
PubMed: 35614616
DOI: 10.47391/JPMA.3716 -
British Medical Journal Aug 1970A survey of recurrent indigestion in four general practices (19,619 patients) showed a wide range of dyspeptic complaints. Of these 82 (4.2 per 1,000) already had a...
A survey of recurrent indigestion in four general practices (19,619 patients) showed a wide range of dyspeptic complaints. Of these 82 (4.2 per 1,000) already had a proved ulcer and 144 (7.3 per 1,000) had symptoms suggesting a duodenal ulcer and had either not been investigated or had previously had a normal barium meal. A duodenal ulcer was found radiologically in half the men (46 out of 95) but in only 16% of the women (8 out of 49). In 11 (25%) of the 46 men shown to have an ulcer a barium meal had been previously reported as normal. Evidence is put forward that ulcer symptoms in the large residue of patients with a normal barium meal (38 men, 29 women) were produced by a primary duodenal condition (duodenitis) of which ulcer was one complication.
Topics: Adult; Aged; Barium Sulfate; Duodenal Diseases; Duodenal Ulcer; Dyspepsia; Enzyme Precursors; Family Practice; Female; Humans; Male; Middle Aged; Pepsin A; Radiography; Sex Factors
PubMed: 4916092
DOI: 10.1136/bmj.3.5719.368 -
Annals of the Royal College of Surgeons... May 1982
Topics: Duodenal Ulcer; Gastrectomy; Humans; Pylorus
PubMed: 7081919
DOI: No ID Found -
Canadian Family Physician Medecin de... May 2004To demonstrate the role of diet in reducing or aggravating risk of duodenal ulcer (DU). (Review)
Review
OBJECTIVE
To demonstrate the role of diet in reducing or aggravating risk of duodenal ulcer (DU).
QUALITY OF EVIDENCE
MEDLINE was searched from January 1966 to December 2001 for articles on the relationship between diet and lifestyle and DU using the key words duodenal ulcer and diet, fibre, or lifestyle. Evidence that these factors are associated with DU arose mainly from three case-control and three prospective studies (level II evidence) and from expert opinion (level III evidence).
MAIN MESSAGE
A high-fibre diet appears to reduce risk of DU; soluble fibre might be associated with reduced risk also. Vitamin A intake is associated with lower risk of DU. Little evidence indicates that fat, type of fat, protein intake, or consumption of alcohol or caffeine affect the etiology of DU.
CONCLUSION
A high-fibre diet, particularly if the fibre comes from fruit and vegetables, could reduce risk of DU; vitamin A might also be beneficial.
Topics: Diet; Dietary Fiber; Duodenal Ulcer; Humans; Life Style
PubMed: 15171675
DOI: No ID Found