AIM:To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district.METHODS:Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospita...AIM:To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district.METHODS:Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively.The subjects were 27patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11,2011.This period was divided into two phases:the acute stress phase,comprising the first month after the earthquake disaster,and the chronic stress phase,from the second through the sixth month.The following items were analyzed according to these phases:age,sex,sites and number of ulcers,peptic ulcer history,status of Helicobacter pylori(H.pylori)infection,intake of non-steroidal anti-inflammatory drugs,and degree of impact of the earthquake disaster.RESULTS:In the acute stress phase from 10 d to 1mo after the disaster,the number of patients increased rapidly,with a nearly equal male-to-female ratio,and the rate of multiple ulcers was significantly higher than in the previous year(88.9%vs 25%,P<0.005).In the chronic stress phase starting 1 mo after the earthquake disaster,the number of patients decreased to a level similar to that of the previous year.There were more male patients during this period,and many patients tended to have a solitary ulcer.All patients with duodenal ulcers found in the acute stress phase were negative for serum H.pylori antibodies,and this was significantly different from the previous year’s positive rate of 75%(P<0.05).CONCLUSION:Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers.展开更多
Although the incidence of postbulbar duodenal ulcers is low, many complications occur, such as hemorrhage, stenosis and perforation, and there are many points to be paid attention to with regard to its pathology. A hi...Although the incidence of postbulbar duodenal ulcers is low, many complications occur, such as hemorrhage, stenosis and perforation, and there are many points to be paid attention to with regard to its pathology. A high acid level has been pointed out as a cause, but this is not conclusive, and its association with Helicobacter pylori (Hp) infection is also unclear. We investigated chronic cases excluding acute cases such as acute duodenal mucosal lesion we encountered between 2001 and 2015. Five cases corresponded, accounting for 1.4% of all chronic duodenal ulcer cases, and there were more male patients (four patients were male), as previously reported. All cases were solitary punched-out ulcer on the medial side near the superior duodenal flexure, and many complications were observed such as melena in all patients, narrowing in 2, and penetration in 1. No specific pathology, such as Crohn’s disease, vasculitis, or Zollinger-Ellison syndrome, was noted, no patient was previously medicated with NSAIDs or low dose aspirin, and 3 patients were infected with Hp. All cases were healed by proton pump inhibitor administration or gastric acid secretion-suppressing treatment with selective proximal vagotomy. Recurrence after Hp eradication occurred in all of the 3 Hp-infected patients, suggesting that involvement of Hp in the cause of disease is unlikely.展开更多
文摘AIM:To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district.METHODS:Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively.The subjects were 27patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11,2011.This period was divided into two phases:the acute stress phase,comprising the first month after the earthquake disaster,and the chronic stress phase,from the second through the sixth month.The following items were analyzed according to these phases:age,sex,sites and number of ulcers,peptic ulcer history,status of Helicobacter pylori(H.pylori)infection,intake of non-steroidal anti-inflammatory drugs,and degree of impact of the earthquake disaster.RESULTS:In the acute stress phase from 10 d to 1mo after the disaster,the number of patients increased rapidly,with a nearly equal male-to-female ratio,and the rate of multiple ulcers was significantly higher than in the previous year(88.9%vs 25%,P<0.005).In the chronic stress phase starting 1 mo after the earthquake disaster,the number of patients decreased to a level similar to that of the previous year.There were more male patients during this period,and many patients tended to have a solitary ulcer.All patients with duodenal ulcers found in the acute stress phase were negative for serum H.pylori antibodies,and this was significantly different from the previous year’s positive rate of 75%(P<0.05).CONCLUSION:Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers.
文摘Although the incidence of postbulbar duodenal ulcers is low, many complications occur, such as hemorrhage, stenosis and perforation, and there are many points to be paid attention to with regard to its pathology. A high acid level has been pointed out as a cause, but this is not conclusive, and its association with Helicobacter pylori (Hp) infection is also unclear. We investigated chronic cases excluding acute cases such as acute duodenal mucosal lesion we encountered between 2001 and 2015. Five cases corresponded, accounting for 1.4% of all chronic duodenal ulcer cases, and there were more male patients (four patients were male), as previously reported. All cases were solitary punched-out ulcer on the medial side near the superior duodenal flexure, and many complications were observed such as melena in all patients, narrowing in 2, and penetration in 1. No specific pathology, such as Crohn’s disease, vasculitis, or Zollinger-Ellison syndrome, was noted, no patient was previously medicated with NSAIDs or low dose aspirin, and 3 patients were infected with Hp. All cases were healed by proton pump inhibitor administration or gastric acid secretion-suppressing treatment with selective proximal vagotomy. Recurrence after Hp eradication occurred in all of the 3 Hp-infected patients, suggesting that involvement of Hp in the cause of disease is unlikely.
