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