| Duodenal Ulcer
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Etiology
• Combination of factors including Helicobacter pylori infection
• Gastric hypersecretion (need intact fundal mucosa) and decreased mucosal defenses
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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,
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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
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General Gross Description
• Sharply demarcated ulcer without heaped up borders located within centimeters of the pylorus
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General Microscopic Description
• Layers from the mucosal surface out include fibrinous exudate, acute inflammation, granulation tissue, fibrosis
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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
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References
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 773-777
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| Duodenal Ulcer
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| Synopsis by: Melinda Sanders M.D. (T64000M38000)[541]
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