Jeck T, Guex A C, Sulser H, Heer M
Medizinische Klinik, Kantonsspital Winterthur.
Schweiz Rundsch Med Prax. 1993 Jun 15;82(24):709-13.
Ischemia is a rare cause of gastric and duodenal ulcers. For the present study clinical and anatomo-pathologic data from cases published so far and from twelve own patients with ischemic ulcers have been investigated. Histopathology leads to the diagnosis of an ischemic cause with great accuracy. Our results show that ischemic ulcers occur often at gastric sites unusual for a peptic ulcer, and in some cases they look macroscopically different from peptic ulcers. The most common symptom was severe gastrointestinal bleeding. Pain, typical for peptic ulcers, has only rarely been noted by patients. Lethal courses were usually due to gastrointestinal bleeding resistant to therapy. Resection of the involved gastric or duodenal segment or surgical or angiologic reconstruction of the vessels respectively are promising therapeutic means. Without therapeutic intervention very different courses have been observed, ranging from spontaneous healing to fatal gastrointestinal bleeding. The benefit of inhibitors of acid secretion is so far unclear.
缺血是胃和十二指肠溃疡的罕见病因。对于本研究，我们调查了迄今为止已发表病例以及12例自身缺血性溃疡患者的临床和解剖病理学数据。组织病理学能够非常准确地诊断出缺血病因。我们的结果表明，缺血性溃疡常发生于消化性溃疡不常见的胃部位，在某些情况下，其宏观表现与消化性溃疡不同。最常见的症状是严重的胃肠道出血。患者很少提及消化性溃疡典型的疼痛。致命病程通常是由于治疗抵抗的胃肠道出血。分别切除受累的胃或十二指肠段或对血管进行外科或血管重建是有前景的治疗方法。未经治疗干预时，观察到的病程差异很大，从自发愈合到致命的胃肠道出血不等。迄今为止，酸分泌抑制剂的益处尚不清楚。
