Eisenberg R L, Margulis A R, Moss A A
Gastrointest Radiol. 1978 Feb 23;2(4):347-53. doi: 10.1007/BF02256518.
Twenty-six giant duodenal ulcers, all correctly diagnosed prior to endoscopy, are presented. The concept of the ulcer/bulb ratio (ratio of longest diameter of the ulcer to that of the total bulb including the ulcer) is introduced. In all cases this ratio was 0.8 or greater; in 18 cases (69%) the ulcer completely replaced the duodenal bulb. An 'ulcer within an ulcer' appearance, representing a small area of deeper ulceration within the giant ulcer, was noted in 8 (31%). Half of the patients have remained symptom-free on medical therapy alone. Only two patients in our series (8%) died of complications of giant duodenal ulcer.
本文报告了26例巨大十二指肠溃疡，所有病例在内镜检查前均得到正确诊断。文中引入了溃疡/球部比率（溃疡最长直径与包括溃疡在内的整个十二指肠球部最长直径之比）这一概念。所有病例的该比率均为0.8或更高；18例（69%）溃疡完全取代了十二指肠球部。8例（31%）出现“溃疡中有溃疡”的表现，即巨大溃疡内有一小片更深的溃疡区域。一半的患者仅通过药物治疗就一直无症状。在我们的系列病例中，只有2例（8%）死于巨大十二指肠溃疡的并发症。
