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| Duodenal Ulcer | ||
| Etiology • Combination of factors including Helicobacter pylori infection • Gastric hypersecretion (need intact fundal mucosa) and decreased mucosal defenses | ||
| Pathogenesis • H. pylori damages mucous layer via urease and proteases, exposing epithelium to gastric acid • May be hypersecreting acid • Other mechanisms of injury may include non-steroidal anti-inflammatory drugs, cigarettes and alcohol, | ||
| Epidemiology • Gastric and duodenal ulcers afflict approximately 4 million in the U.S. • Duodenal ulcers associated with alcoholism, chronic lung and renal disease, and hyperparathyroidism | ||
| General Gross Description • Sharply demarcated ulcer without heaped up borders located within centimeters of the pylorus •Examples: | ||
| General Microscopic Description • Layers from the mucosal surface out include fibrinous exudate, acute inflammation, granulation tissue, fibrosis •Examples: | ||
| Clinical Correlation • Medical treatment directed at H. pylori is frequently effective • Surgery for complications such as erosion into adjacent organs, perforation, or erosion into vessels • Obstruction due to scarring may also complicate an ulcer | ||
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 773-777 Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window Duodenal Ulcer
| Synopsis by: Melinda Sanders M.D. (T64000M38000)[541]
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