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Gastric ulcer

1. ¼­·Ð

50´ë¿¡ peak(DUº¸´Ù 10³âÀÌ ´Ê´Ù)

DU¿Í Á¶Á÷ÇÐÀûÀ¸·Î ºñ½ÁÇϳª ulcerÁÖÀ§¿¡ gastritis°¡ º¸´Ù ±¤¹üÀ§ÇÏ´Ù.

benign GU´Â stomach fundus¿¡´Â µå¹°´Ù.

Benign GU´Â Ç×»ó antral gastritis°¡ µ¿¹ÝµÇ¾î Àִµ¥ ÀÌ´Â H.pylori infection

¶§¹®ÀÌ¸ç ´Ù¾çÇÑ Á¤µµÀÇ mucosal atrophy°¡ ÀÖ´Ù.

AspirinÀ̳ª NSAID¿Í °ü·ÃÀÌ ÀÖÀ»¶§´Â ÈçÈ÷ gastritis°¡ ¾ø´Ù.

2. ¿øÀÎ ¹× º´ÀÎ

¨ç DUó·³ GU¿¡¼­µµ acid, pepsinÀÌ º´Àο¡ Áß¿äÇѵ¥

DU¿¡¼­¿Í ¹Ý´ë·Î GU´Â acid secretion rate°¡ Á¤»ó°ú °°°Å³ª ³·´Ù.

¨è DU & GU°¡ °°ÀÌ ÀÖÀ»¶§´Â acid secretory patternÀº DU¿Í °°´Ù.

* H.pylori infectionµÈ °æ¿ì ¾î¶² »ç¶÷Àº DU°¡ »ý±â°í ¾î¶² »ç¶÷Àº GU°¡ »ý±æ±î?

±× ÀÌÀ¯´Â ¸íȮġ ¾ÊÀ¸³ª ¾î¸°¾ÆÀ̶§ H. pylori¿¡ °¨¿°µÇ¸é GU°¡ ´õ ÈçÇѵ¥,

chronic or atrophic gastritis¸¦ ÀÏÀ¸ÄÑ gastric acid secretionÀ» °¨¼Ò½ÃÄÑ

±× °á°ú DUÀÇ À§ÇèÀº ³·°í GU, Gastric cancer risk´Â ³ô¾ÆÁø´Ù.

¨é Serum gastrin levelÀº Á¤»óº¸´Ù ³ô´Ù.

¨ê Gastric emptyingÀº delayµÇ¾î ÀÖ°í

Duodenal regurgitationÀ¸·Î ÀÎÇÏ¿© gastric mucosal injury & subsequent GU°¡ »ý±ä´Ù.

3. ÀÓ»óÀû Ư¡

¨ç mc - epi pain

½Ä»çÈÄ ¾ÇÈ­

À½½ÄÀ̳ª Á¦»êÁ¦ º¹¿ëÈÄ Áõ»óÀÌ È£ÀüµÇ³ª DUº¸´Ù´Â ´úÇÔ

¨è N/V - DU¿¡¼­´Â gastric outlet obstruction¿¡ ÀÇÇØ ¹ß»ýÇϳª

GU¿¡¼­´Â gastric outlet obstruction¾øÀ̵µ ¹ß»ýÇÑ´Ù.

¨é hemorrhage : GU CxÁß °¡Àå ÈçÇÔ(25%)

¨ê perforation : less common

but mortality´Â DU perforationÀÇ 3¹è°¡ µÈ´Ù.

¡ñ soilage¡è & diagnosis delay