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2010-07-14 #1.1

Comparison of gastric ulcers & duodenal ulcers

FeatureGastric ulcersDuodenal ulcers
epidemiology male/female ratio 1:1; smoking does not cause PUD but delays healing male/female ratio 2:3; risk increased with MEN I; increased risk in cirrhosis, COPD, renal failure, hyperparathyroidism
Helicobacter pylori 80 90~95
pathogenesis defective mucosal barrier due to H.pylori; mucosal ischemia (reduced PGE). bile reflux, delayed gastric emptying; BAO & MAO normal to decreased defective mucosal barrier due to H.pyloria; increased acid production (increased parietal cell mass); BAO & MAO both increased
location single ulcer on lesser curvation of antrum; same location for cancer single ulcer on anterior portion of 1st part of duodenum followed by single ulcer on posterior portion; danger of perforation into pancreas & pancreatitis
complication bleeding (MC in left gastric a.); perforation bleeding (MC in gastroduodenal a.); perforation (air under diaphragm, pain radiates to left or right shoulder); gastric outlet obstruction; pancreatitis
clinical findings epigastric pain exacerbated by eating epigastric pain relieved by pain
diagnosis endoscopy; must biopsy gastric ulcers due to malignancy; endoscopy; X biopsy gastric ulcers due to malignancy;
percentage of ulcer cases 25 75
Created by: mataos
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