Ulcer antral

S. Onodera, M. Tanaka, M. Aoyama, Y. Arai, N. Inaba, T. Suzuki, A. Nishizawa, M. Shibata, Y. Sekine (1999) Antiulcer effect of lafutidine on indomethacin-induced gastric antral ulcers in refed rats. Jpn. J. Pharmacol., 80, 229-235. 

H. Yamamoto, S. Horie, M. Uchida, S. Tsuchiya, T. Murayama, K. Watanabe (2001) Effects of vanilloid receptor agonists and antagonists on gastric antral ulcers in rats. Eur. J. Pharmacol., 432, 203-210. 

Fig. 3.25. An antral ulcer with a necrotic ulcer base and bleeding spots at the ulcer rim. The patient presented with iron-deficiency anaemia and was Helicobacter pylori-positive...

Fig. 3.28. Chronic antral ulcer with scar formation and narrowing of the pylorus, slightly displaced...

Fig. 4.6a,b. Antral ulcer. This large deep antral gastric ulcer was not observed at endoscopy because the ulcer crater was obscured by luxuriant inflamed gastric folds... 

Ogino, K., Hobara, T., Ishiyama, H., Yamasaki, K., Kobayashi, H., Izumi, Y. and Oka, S. (1992). Antiulcer mechanism of action of rebamipide, a novel antiulcer compound, on diethyldithiocarbamate-induced antral gastric ulcers in rats. Eur. J. Pharmacol. 212, 9-13. 

Gastric ulcer Gastric ulcer may produce a delay in gastric emptying time and may complicate therapy (antral stasis). 

Helicobacter pylori H. pylori is found in approximately 100% of chronic active antral gastritis cases, 90% to 95% of duodenal ulcer patients, and 50% to 80% of gastric ulcer patients. The treatment of documented H. pylori infection in patients with confirmed peptic ulcer on first presentation or recurrence has been recommended by the National Institutes for Health in a 1994 Consensus Conference. Once H. py/on eradication has been achieved, reinfection rates are less than 0.5% per year, and ulcer recurrence rates are dramatically reduced. 

In addition, steroid ulcer has been related recently to mucin deficiency caused by this therapy. Menguy and Masters injected steroids into rats with denen ated antral pouches (M28). They found substantially decreased mucus secretion, as well as compositional change of antral mucus characterized by decrease in its sialic acid concentration (Fig. 14). They concluded that the steroids interfered with the rate of the mucous barrier renewal, caused decreased mucus production, and lowered the threshold of gastric mucosal susceptibility to peptic digestion. Robert and his associates studied the relationship of the mucus secretion to the development of ulcers in fasting rats (R7), as well as in those given large doses of steroids (R8). They determined mucus content by quantitation of hexosamine and found decrease in concentration and output in rats who developed ulcers. The latter appeared only in that portion... 

Harper et al. (HI) found no significant difference between the concentration of gastrin in antral extracts from cases of gastric ulcer and normal individuals. In duodenal ulcer, however, antral gastrin concentration was about twice that in gastric ulcer, and its concentration correlated with both the basal secretion and the response intensity to a maximal histamine stimulation. 

Antral or prepyloric ulcers and erosive gastritis were identified after 12 of 84 courses of interleukin-4 in 72 patients, of whom three suffered from life-threatening bleeding. There were no treatment-related deaths and no clear correlation with the dose of interleukin-4. A possible protective effect of interleukin-2 on the... 

HPI OF is a 42-year-old white man who presents to the acute care clinic with severe mid-epigastric pain. OF has been working long hours and is under a great deal of stress at work. OF drinks one to two beers per night, and has smoked one pack of cigarettes per day for the past 10 years. He has lost 10 pounds in the past 2 months. PE Endoscopy reveals a 4-cm gastric ulcer (antral), which tests positive for Helicobacter pylori. ... 

Most peptic ulcers occur in the presence of acid and pepsin when HP, NSAIDs, or other factors (see Table 33-2) disrupt normal mucosal defense and healing mechanisms. Hypersecretion of acid is the primary pathogenic mechanism in hypersecretory states such as ZES. Ulcer location is related to a number of etiologic factors. Benign gastric ulcers can occur anywhere in the stomach, although most are located on the lesser curvature, just distal to the junction of the antral and acid-secreting mucosa (see Fig. 33-1). Most duodenal ulcers occur in the first part of the duodenum (duodenal bulb). 

H. pylori infection is well known as the causative agent of antral gastritis and peptic ulcer disease (see Sect. 3.4.2). On barium studies, the most frequent finding will be (markedly) thickened gastric folds, or even thickened and lobulated gastric folds can be seen. 

Kelly (Kelly 1991) suggested that these lesions were quite common in the population as they were detected in 8 of a series of 118 resected colonic specimens. The polyp-simulating mucosal prolapse syndrome is histologically similar to the prolapse described in the solitary rectal ulcer syndrome, inflammatory cloacogenic polyps and gastric antral vascular ectasia (Tendler et al. 2002) (Fig. 8.41). 

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