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2010-07-14 #1.1
Comparison of gastric ulcers & duodenal ulcers
Feature | Gastric ulcers | Duodenal 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 |