Peptic ulcers occur in presence of Acid and Pepsin. The two main types are gastric and duodenal but they can also occur at GJ Stoma, lower end of esophagus
Etiology: Disruption of gastric mucosal barrier appears as multiple erosions. 50% of patients give history of NSAID/aspirin intake and classically they present with hemorrhage.
Pathology: Frequently multiple.
Stomach - They can occur in any part.
Duodenum - Almost always confined to first part.
Shallow punched out and seldom invade musclecoats unlikely to leave scars healing.
Clinical features: Short lived attacks of dyspepsia - not recognized. Haemetemesis - recognized.
Acute duodenal ulcer in anterior wall occasionally perforates. These acute lesions can progress to chronic ulcers.
Cause must be removed.
Medical management has good response.
Blood - transfusions for haemetemesis.
Dietetic irregularities to be corrected.
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