Peptic ulcer disease презентация

and metaplasia into duodenal mucosa
Failure of gastroduodenal movement
Genetic susceptibility

and pepsin,and on the suppression of acid as a treatment strategy.
Gastric hypersecretion-associated with gastrinoma in Zollinger-Ellision syndrome,antral G-cell hyperplasia,an increase in parietal-cell mass and physiological imbalance between the antagonistic gastric hormones gastrin and somatostatin-is still an important issue in peptic ulcer disease.

prostaglandin E2 reduces the risk if ulcer complications,but only at the recommended dose of 800 ug/day.
Lower doses of misoprostol are not effective

GIT bleeding.

2. Indirect indications:
Penetration into contiguous organs.
Giant ulcer.
Recurrence bleeding.
Long –term medical history with recurrences of ulcer
Unsuccessful drugs therapy .

Indirect indications are changeable according trials.

contiguous organs;
Recurrence bleeding;
Long –term medical history with recurrences of ulcer with unsuccessful drug therapy.

According to our experience indications for duodenal ulcer surgery are:

ulcer (perforation, bleeding, penetration);

2) no effect drug therapy fro three months;

3) Long –term medical history with recurrences of ulcer with unsuccessful drug therapy;

4) Chronic ulcer with epithelial dysplasia IIIst or /and metaplasia
subcardial [juxtacardial, type IV gastric] ulcer.

lesser curvature of stomach ( 3 sм under pylorus),
II type — combined ulcer`s of duodenum and stomach,
III type — ulcer`s of pylorus ( up to 3 sм).
IV type - subcardial ( juxtacardial ) ulcer (up to 2 sм from esophagus sphincter)
V type — drug related ulcers