Giant duodenal ulcer

Lumsden, K.; MacLarnon, J.C.; Dawson, John

doi:10.1136/gut.11.7.592

Cited by 27 publications

(11 citation statements)

References 8 publications

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“…Although Mistilis [2] and Kirsh et al [6] proposed that the diagnosis of a giant duodenal ulcer was an indication for surgery, Lumsden [4] has suggested that a course of intensive medical therapy be attempted first. Our series strongly supports the latter view.…”

Section: Discussionmentioning

confidence: 99%

Giant duodenal ulcers

Eisenberg

Margulis

Moss

1977

Gastrointest Radiol

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Twenty-six giant duodenal ulcers, all correctly diagnosed prior to endoscopy, are presented. The concept of the ulcer/bulb ratio (ratio of longest diameter of the ulcer to that of the total bulb including the ulcer) is introduced. In all cases this ratio was 0.8 or greater; in 18 cases (69%) the ulcer completely replaced the duodenal bulb. An 'ulcer within an ulcer' appearance, representing a small area of deeper ulceration within the giant ulcer, was noted in 8 (31%). Half of the patients have remained symptom-free on medical therapy alone. Only two patients in our series (8%) died of complications of giant duodenal ulcer.

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Section: Discussionmentioning

confidence: 99%

Giant duodenal ulcers

Eisenberg

Margulis

Moss

1977

Gastrointest Radiol

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“…Similarly, barium contrast studies may miss giant duodenal ulcers, which, because of their large size, may be mistaken for the entire duodenal bulb, a pseudodiverticulum, or a true diverticulum of the duodenal bulb. 32 Endoscopy is also important in ruling out malignancy and rare causes of giant ulcers such as Crohn's disease, 33 eosinophilic gastroenteritis, 34 and ischemia 35 and may be required for the management of complications associated with giant ulcers. There are no data that clearly demonstrate improved clinical outcomes from surveillance endoscopy of giant peptic ulcers, although surveillance and documentation of healing could be justified, based on the increased rates of adverse outcomes associated with these lesions.…”

Section: Giant Ulcersmentioning

confidence: 99%

The role of endoscopy in the management of patients with peptic ulcer disease

Banerjee¹,

Cash²,

Dominitz³

et al. 2010

Gastrointestinal Endoscopy

121

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“…Giant duodenal ulcer is defined as DU greater than 2 cm in diameter [93]. Doubt exists whether giant DU is better treated medically or surgically.…”

Section: Special Ulcer Problemsmentioning

confidence: 99%

The refractory ulcer

1987

World J. Surg.

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The termrefractoryis applied to those ulcers that fail to heal despite 3 months of active treatment, recur within 1 year despite maintenance therapy with H2‐receptor antagonists, or, in the untreated state, persist without remission. Approximately 20–30% of ulcers fulfill 1 of these 3 criteria. Factors often associated with a refractory ulcer include large ulcer size, gastric outlet obstruction, hour‐glass deformity, penetration, Candida infection, and cimetidine resistance. Incomplete healing of the ulcer and/or initial treatment with H2‐receptor antagonists may predispose to a refractory long‐term course. Successful treatment of the refractory ulcer correlates more with duration of treatment than with the drug used. The more potent antisecretory agents, such as omeprazole, may be the drug of choice. The role of smoking and other environmental factors is not clear.

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Giant duodenal ulcer

Cited by 27 publications

References 8 publications

Giant duodenal ulcers

Giant duodenal ulcers

The role of endoscopy in the management of patients with peptic ulcer disease

The refractory ulcer

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