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duodenal ulcer caused by coil wiggle after digital subtraction angiography-guided embolization: A case report

World Journal of Clinical Cases 2021年第33期9卷 10315-10322页

作者： Sheng Xu Shou-Xing Yang Zhan-Xiong Xue Chang-Long Xu Zhen-Zhai Cai Chang-Zhao Xu Department of Gastroenterology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND Acute gastrointestinal bleeding(GIB)is a life-threatening medical emergency with high morbidity and *** embolization with endovascular coils under digital subtraction angiography guidance is a common and effective method for the treatment of GIB with high technical success *** ulcers caused by coils wiggled from the branch of the gastroduodenal artery,which is a rare complication,have not previously been reported in a patient with right intrathoracic *** SUMMARY A 62-year-old man had undergone thoracoscopy-assisted radical resection of esophageal cancer and gastroesophageal anastomosis 3 years ago,resulting in right intrathoracic *** was admitted to the hospital 15 mo ago for dizziness and suffered acute GIB during his *** surgery was urgently performed to embolize the branch of the gastroduodenal artery with endovascular *** 15 mo,the patient was re-admitted with a chief complaint of melena for 2 d,esophagogastroduodenoscopy and abdominal computed tomography revealed that some endovascular coils had migrated into the duodenal bulb,leading to a deep *** was controlled after conservative *** months later,duodenal balloon dilatation was performed to relieve the stenosis after the removal of a few coils,and the patient was safely discharged with only one coil retained in the duodenum due to difficulties in complete removal and risk of *** melena recurred once during the long-term *** Although rare,coil wiggle after interventional therapy requires careful attention,effective precautionary measures,and more secure alternative treatment methods.

关键词： Digital subtraction angiography Endoscopy Esophageal neoplasms Gastrointestinal hemorrhage duodenal ulcer Case report

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Helicobacter pylori infection alters gastric microbiota structure and biological functions in patients with gastric ulcer or duodenal ulcer

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World Journal of Gastroenterology 2024年第24期30卷 3076-3085页

作者： Ling-Xiao Jin Yu-Peng Fang Chen-Mei Xia Teng-Wei Cai Qian-Qian Li Yu-Yin Wang Hai-Fan Yan Xia Chen Department of Gastroenterology Wenling Hospital of Wenzhou Medical University(The First People’s Hospital of Wenling)Wenling 317500Zhejiang ProvinceChina

BACKGROUND Helicobacter pylori(***)infection is closely associated with gastrointestinal *** preliminary studies have indicated that *** infection had a significant impact on the mucosal microbiome structure in patients with gastric ulcer(GU)or duodenal ulcer(DU).AIM To investigate the contributions of *** infection and the mucosal microbiome to the pathogenesis and progression of ulcerative *** Patients with *** infection and either GU or DU,and healthy individuals without *** infection were *** or duodenal mucosal samples was obtained and subjected to metagenomic *** compositions of the microbial communities and their metabolic functions in the mucosal tissues were *** Compared with that in the healthy individuals,the gastric mucosal microbiota in the ***-positive patients with GU was dominated by ***,with signi-ficantly reduced *** intergroup differential functions,which were enriched in the ***-positive GU patients,were all derived from ***,particularly those concerning transfer RNA queuosine-modification and the synthesis of demethylmenaquinones or menaquinones.A significant enrichment of the uibE gene was detected in the synthesis *** was no significant difference in microbial diversity between the ***-positive DU patients and healthy *** *** infection significantly alters the gastric microbiota structure,diversity,and biological functions,which may be important contributing factors for GU.

关键词： Helicobacter pylori Gastric ulcer duodenal ulcer Metagenomic sequencing Transfer RNA queuosine-modification Menaquinones

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History of Helicobacter pylori,duodenal ulcer,gastric ulcer and gastric cancer

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World Journal of Gastroenterology 2014年第18期20卷 5191-5204页

作者： David Y Graham Michael E DeBakey VA Medical Center Baylor College of MedicineHoustonTX 77030United States

Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician’s believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for “surgical disease” or for “Sippy” diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of

关键词： Helicobacter pylori duodenal ulcer Gastric ulcer Gastric cancer Medical history ulcer surgery Epidemiology Gastritis Atrophic gastritis Antiquity

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Post-bulbar duodenal ulcer with anterior perforation with kissing ulcer and duodenocaval fistula:A case report and review of literature

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World Journal of Clinical Cases 2022年第25期10卷 9071-9077页

作者： Nasser Alzerwi Department of Surgery College of MedicineMajmaah UniversityRiyadh 66RiyadhSaudi Arabia

BACKGROUND A post-bulbar duodenal ulcer(PBDU)is an ulcer in the duodenum that is distal to the duodenal *** may coexist with a synchronous posterior ulcer in rare occurrences,resulting in a kissing ulcer(KU).Duodenocaval fistula(DCF)is another uncommon but potentially fatal complication related to *** is limited knowledge of the scenarios in which PBDU is complicated by KU and DCF *** SUMMARY A 22-year-old man was admitted to the emergency department with abdominal pain,stiffness,and *** X-ray showed pneumoperitoneum,suggesting a perforated *** revealed a KU with anterior perforation and a *** Kocherization,venorrahphy was used to control caval *** to the critical condition of the patient,only primary duodenorrahphy with gastrojejunostomy was performed as a damage control ***,later,the patient developed obstructive jaundice and leakage,and two additional jejunal perforations were *** to the poor condition of the duodenum and the involvement of the ampulla in the posterior ulcer,neither primary repair nor pancreatic-free duodenectomy and ampull-oplasty/ampullary reimplantation were considered viable;therefore,an emergency pancreaticoduodenectomy was performed,along with resection and anastomosis of the two jejunal *** patient had a smooth recovery after surgery and was discharged after 27 *** The timely diagnosis of PBDU and radical surgery can aid in the smooth recovery of patients,even in the most complex cases.

关键词： duodenal ulcer Duodenocaval fistula Kissing ulcer Emergency Whipple’s surgery Case report

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Effect of Xiaokuiling Prescription on the Expression of HSP_(72) , HSP B in Gastric Mucosa of Patients with Helicobacter Pylori associated duodenal ulcer

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2001年第4期21卷 310-313页

作者：易屏李国成刘胜洪罗树星陶秀良 Department of Traditional Chinese Medicine Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030

In order to investigate the mechanism of Xiaokuiling prescription (XKL) in the treatment of Helicobacter pylori (HP) associated duodenal ulcer (DU) and the pathophysiologic role of heat shock proteins (HSPs) in the healing of ulcer, the expression of HSP 72 and HSP B in gastric mucosa was detected by using SABC immunohistochemistry method and processed by micro image analysis system. The method of Western blotting was used to measure the contents of HSP 72 and HSP B in the tissue emulsion of gastric mucosa. The results were as follows: (1) HSP 72 expression of the gastric mucosa in the treated group was obviously increased as compared with that in the control group ( P ulcer.

关键词： duodenal ulcer helicobacter pylori heat shock proteins immunohistochemistry Western blotting

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Emergency transcatheter arterial embolization for patients with acute massive duodenal ulcer hemorrhage

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World Journal of Gastroenterology 2012年第34期18卷 4765-4770页

作者： Yong-Li Wang Ying-Sheng Cheng Li-Zhen Liu Zhong-Hui He Kun-Hong Ding Department of lnterventional Radiology Fengxian Branch Hospital of Affiliated 6th People's Hospital of Shanghai Jiaotong University Shanghai 201400 China Department of Diagnostic and Interven- tional Radiology Shanghai Jiaotong University Affiliated 6th People's Hospital Shanghai 200233 China

AIM：To evaluate the efficacy and safety of emergency transcatheter arterial embolization （ETAE） for patients with acute massive duodenal ulcer hemorrhage. METHODS：Twenty-nine consecutive patients with acute massive bleeding of duodenal ulcer were admitted to our hospital from 2006 to 2011. Superselective angiography of the celiac and gastroduodenal arteries was performed to find out the bleeding sites before ETAE, then, embolotherapy was done with gelatin sponge particles or microstrips via a 5 French angio-graphic catheter or 3 French microcatheter. After ETAE, further superior mesenteric arteriography was under-taken in case collateral circulation supplied areas of the duodenal ulcer. Technical and clinical success rates were analyzed. Changes in the mucous membrane were observed using endoscopy following ETAE. RESULTS：Angiography showed active bleeding with extravasation of contrast medium in seven cases with a 24% positive rate of celiac artery bleeding, and in 19 cases with a 65.5% rate of gastroduodenal artery bleeding. There were no angiographic signs of bleeding in three patients who underwent endoscopy prior to ETAE. Twenty-six patients achieved immediate hemostasis and technical success rate reached 90%. No hemostasis was observed in 27 patients within 30 d after ETAE and clinical success rate was 93%. Recurrent hemorrhage occurred in two patients who drank a lot of wine who were treated by a second embolotherapy in the same way. Five patients underwent transient ischem with light abdominal pain under xiphoid, spontaneous restoration without special treatment. No mucous necrosis happened to 29 cases for ischem of gastroduodenal arteries embolized. CONCLUSION：ETAE is an effective and safe measure to control acute massive bleeding of duodenal ulcer.

关键词： Transcatheter embolization Massive bleed-ing duodenal ulcer Angiography

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Perforated duodenal ulcer presenting with massive hematochezia in a 30-month-old child

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World Journal of Gastroenterology 2009年第38期15卷 4853-4855页

作者： Na Mi Lee Sin Weon Yun Soo Ahn Chae Byoung Hoon Yoo Seong Jae Cha Byung Kook Kwak Department of Pediatrics College of MedicineChung-Ang University Department of General Surgery College of MedicineChung-Ang University Department of Radiology College of MedicineChung-Ang University

Peptic ulcer disease is uncommon in children and rarely suspected as a cause of abdominal complaints in this age group; the diagnosis is therefore made almost exclusively when complications develop. Peptic ulcer disease is usually not considered in the differential diagnosis of pediatric patients. We present the case of a 30-month-old boy with duodenal perforation due to a peptic ulcer without a known etiology. The patient was admitted through the emergency department due to severe hematochezia and ongoing anemia; he presented with neither abdominal pain nor abdominal distension. There were no medical problems, and no drugs, such as corticosteroids or nonsteroidal anti-inflammatory drugs, had been prescribed or administered recently. We tried to control the active bleeding by medical treatment including arterial embolization, but the active bleeding was not controlled. Finally, an exploratory laparotomy was performed. A discrete anterior perforation with active bleeding of the duodenal wall was found. After the operation, there were no complications and the patient recovered fully.

关键词： duodenal ulcer Peptic ulcer perforation Children Hematochezia Hemorrhage

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Management of duodenal ulcer bleeding

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Chinese Medical Journal 1998年第1期111卷 3-6页

作者：黎锦泉林兆鑫 Division of Gastroenterology Department of Medicine University of Hong Kong Hong Kong China

ＭａｎａｇｅｍｅｎｔｏｆｄｕｏｄｅｎａｌｕｌｃｅｒｂｌｅｅｄｉｎｇＫａｍＣｈｕｅｎＬａｉ黎锦泉ａｎｄＳｈｉｕＫｕｍＬａｍ林兆鑫ＤｉｖｉｓｉｏｎｏｆＧａｓｔｒｏｅｎｔｅｒｏｌｏｇｙ，ＤｅｐａｒｔｍｅｎｔｏｆＭｅｄｉｃｉ... 详细信息

ＭａｎａｇｅｍｅｎｔｏｆｄｕｏｄｅｎａｌｕｌｃｅｒｂｌｅｅｄｉｎｇＫａｍＣｈｕｅｎＬａｉ黎锦泉ａｎｄＳｈｉｕＫｕｍＬａｍ林兆鑫ＤｉｖｉｓｉｏｎｏｆＧａｓｔｒｏｅｎｔｅｒｏｌｏｇｙ，ＤｅｐａｒｔｍｅｎｔｏｆＭｅｄｉｃｉｎｅ，ＵｎｉｖｅｒｓｉｔｙｏｆＨｏ...

关键词： duodenal ulcer Humans Peptic ulcer Hemorrhage

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Assay of gastrin and somatostatin in gastric antrum tissues of children with chronic gastritis and duodenal ulcer

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World Journal of Gastroenterology 2006年第14期12卷 2288-2290页

作者： Xiao-Zhi Xie Zhi-Guang Zhao Dan-Si Qi Zong-Min Wang Department of Pathology Children's Hospital of Wenzhou Medical College Wenzhou 325027 Zhejiang Province China

AIM： To study the expressions of gastrin （GAS） and somatostatin （SS） in gastric antrum tissues of children with chronic gastritis and duodenal ulcer and their role in pathogenic mechanism. METHODS： Specimens of gastric antrum mucosa from 83 children were retrospectively analyzed. Expressions of GAS and SS in gastric antrum tissues were assayed by the immunohistochemical Fn Vision method. RESULTS： The expressions of GAS in chronic gastritis Hp＋ group （group A）, chronic gastritis Hp-group （group B）, the duodenal ulcer Hp＋group （group C）, duodenal ulcer Hp group （group D）, and normal control group （group E） were 28.50＋4.55, 19.60＋2.49, 22.69＋2.71, 25.33 ＋ 4.76, and 18.80 ＋ 2.36, respectively. The value in groups A-D was higher than that in group F. The difference was not statistically significant. The expressions of SS in groups A-E were 15.47＋ 1.44, 17.29＋ 2.04, 15.30＋ 1.38, 13.11 ＋0.93 and 12.14＋ 1.68, respectively. The value in groups A-D was higher than that in group F. The difference was also not statistically significant. CONCLUSION： The expressions of GAS and SS are increased in children with chronic gastritis and duodenal ulcer.

关键词： Chronic gastritis duodenal ulcer Gastrin Somatostatin

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Response of blood endothelin-1 and nitric oxide activity in duodenal ulcer patients undergoing Helicobacter pylori eradication

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World Journal of Gastroenterology 2005年第7期11卷 1048-1051页

作者： Full-Young Chang Chih-Yen Chen Ching-Liang Lu Jiing-Chyuan Luo Rei-Hwa Lu Shou-Dong Lee Division of Gastroenterology

AIM: To investigate the effect of Helicobacter pylori eradication on endothelin-1 (ET-1) and nitric oxide (NO) in duodenal ulcer (DU) patients. METHODS: Sixty-six Hpylori-infected active DU patients were consecutively enrolled to receive one-week triple therapy (rabeprazole, amoxicillin and metronidazole) and then one-month rabeprazole therapy. They were asked back to determine ulcer and Hpylori status using endoscopy one month later. Thirty-seven healthy controls (H pylori +/-:17/20) were enrolled for comparison. Blood samples were collected in each visit to measure plasma ET-1 and nitrate/nitrite levels using an enzyme immunoassay kit. RESULTS: Sixty DU patients finished trial per protocol. The ulcer healing and Hpylori-eradication rates were 86.7% and 83.3%, respectively. Plasma ET-1 level in DU patients was higher than that of Hpylori-negative and positive controls (3.59±0.96 vs0.89±0.54 vs0.3±0.2 pg/mL,P<0.01), while nitrate/nitrite levels among them were also significantly different (8.55±0.71 vs5.27±0.68 vs 6.39±0.92 μmol/L, P<0.05). H pylori eradication diminished ET-1 levels (3.64±0.55 vs2.64±0.55 pg/mL, P<0.01) but elevated nitrate/ nitrite level (8.16±0.84 vs11.41±1.42 umol/L,P<0.05). CONCLUSION: Both plasma ET-1 and nitrate/nitrite levels increase in active DU patients. After an effective H pylori eradication, DU healing is associated with diminished blood ET-1 level and elevated nitrate/nitrite level.

关键词： duodenal ulcer Endothelin-1 Helicobacter pylori Nitric oxide

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