Symptomatic gastroduodenal ulcers and peptic ulcer: similarity and differences?
Abstract
Aim of the review. To define symptomatic gastroduodenal ulcers (SGDU), to demonstrate necessity of their timely diagnostics, treatment and prophylaxis according to presented data.
The recent literature data. Gastroduodenal ulcers can be a manifestation not only of peptic ulcer disease with its complex polyetiologic nature. In contrast to the latter, SGDU are secondary lesions intimately related in pathogenesis to other background diseases or extreme effects. For such ulcers it is typical that one factor or group of pathogenic factors break the balance between aggressive and protective mucosal factors, becoming leading in ulcerogenesis. Differential diagnostics with peptic ulcer disease is a difficult challenge. For symptomatic ulcers the cause should be revealed. For SGDU multiplicity of ulceration, localization at the stomach outlet, frequency of asymptomatic course and tendency to bleedings are typical. Surviving of patients after extensive surgeries and traumas, acute disorders of vital body functions, maintaining of life of patients with severe somatic diseases can result in development of gastroduodenal ulcers and death of massive erosive-ulcerative gastroduodenal bleeding even at successful treatment of the basic disease. Treatment and prophylaxis of SGDU in many respects depend on their type and presence of complications. For patients with uncomplicated ulcers, first of all, it is necessary to treat actively the primary disease and its complications, and to eliminate the causes of ulceration as well. Antiulcerative treatment taking into account specificity of ulcerogenesis should be carried out simultaneously. Medical algorithm at bleeding SGDU differs slightly from that at bleeding ulcers in patients with peptic ulcer disease.
Conclusion. Symptomatic ulcers are the secondary ulcers pathogeneticly linked to other diseases of internal organs. They should be differentiated from peptic ulcer, it is necessary to define the basic ethipathogenic factor and develop management algorythm on this basis.
About the Author
A. V. Kalinin
Государственный институт усовершенствования врачей МО РФ, Главный военный клинический госпиталь им. Н.Н. Бурденко
Russian Federation
Russian Federation
References
1. Василенко В.Х. Чего мы не знаем о язвенной болезни? // Актуальные вопросы гастроэнтерологии. – 1970. – № 2. – С. 17–22.
2. Гребенев А.Л. Шептулин А.А. Симптоматические язвы желудка и двенадцатиперстной кишки: Руководство по гастроэнтерологии: В 3 т. / Под ред. Ф.И. Комарова, А.Л. Гребенева. – T. 1. Болезни пищевода и желудка. – М.: Медицина, 1995. – С. 534–550.
3. Калинин А.В. Симптоматические гастродуоденальные язвы // Гастроэнтерология и гепатология. Диагностика и лечение / Под ред. А.В. Калинина, А.И. Хазанова. – М.: Миклош, 2007. – С. 95–98.
4. Калинин А.В. Симптоматические гастродуоденальные язвы и гастродуоденальные язвы при язвенной болезни // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2004. – Т. 14, № 3. – С. 22–32.
5. Симптоматические гастродуоденальные язвы // Диагностика и лечение внутренних болезней: Руководство для врачей: В 4 т. / Под общ. ред. Ф.И. Комарова. – Т. 3. Болезни органов пищеварения / Под ред. А.И. Хазанова. – М.: Медицина, 2003. – С. 89–100.
6. Уголев A.M., Радбиль О.С. Гормоны пищеварительной системы: Физиология, патология, теория функциональных блоков. – М.: Наука, 1995. – 238 с.
7. Wormsley K.G. Association between duodenal ulcer and other diseases // Scand. J. Gastroenterol. – 1980. – Vol. l5 (suppl. 63). – P. 27–35.
8. Zollinger H., Ellison E., O’Dorison T. et al. Thirty years experience with gastrinoma // Word. J. Surg. – 1984. – Vol. 8. – P. 427–435.
Review
For citations:
Kalinin A.V. Symptomatic gastroduodenal ulcers and peptic ulcer: similarity and differences? Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(1):59-68. (In Russ.)
Views:
1
Email this article 
