Since 1980s. a revolution has overturned understanding of peptic ulcer: peptic ulcer occurs in two common forms associated with helicobacter pylori and consumption of nonsteroidal anti inflammatory drugs (NSAIDS), including aspirin. There are a few uncommon causes to consider This revolution demands a dramatic change in clinical management
Since 1980s, a revolution has overturned understanding of peptic ulcer: peptic ulcer occurs in two common forms associated with helicobacter pylori and consumption of nonsteroidal antiinflammatory drugs (NSAIDs), including aspirin. There are a few uncommon causes to consider . This revolution demands a dramatic change in clinical management
病理 DU多发生在球部,前壁较常见 GU多在胃角和胃窦小弯。组织学上GU 多发生在幽门腺区(胃窦)与泌酸腺 区(胃体)交界处的幽门腺区一侧。 老年患者GU的部位多较高。DU直径 多小于10mm,GU>DU。溃疡浅者累 及粘膜肌层,深者达肌层甚至浆膜层
病理 DU多发生在球部，前壁较常见 GU多在胃角和胃窦小弯。组织学上GU 多发生在幽门腺区（胃窦）与泌酸腺 区（胃体）交界处的幽门腺区一侧。 老年患者GU的部位多较高。DU直径 多小于10mm，GU>DU。溃疡浅者累 及粘膜肌层，深者达肌层甚至浆膜层
临床表现 本病的临床表现不一,部分患者可无症 状,部分以出血、穿孔为首发症状。 典型的消化性溃疡具有: 1慢性反复发作过程 2周期性发作 3发作呈节律性
临床表现 本病的临床表现不一，部分患者可无症 状，部分以出血、穿孔为首发症状。 典型的消化性溃疡具有： 1.慢性反复发作过程 2.周期性发作 3.发作呈节律性
症状 ●上腹痛:钝痛、灼痛、胀痛或剧痛,亦 有饥饿样不适感。 ●DU患者约2/3疼痛呈节律性,多为饥饿 性疼痛12呈夜间痛。(?) GU患者也可发生规律性疼痛,但多为餐 后痛。偶有夜间痛。 ●溃疡痛是一种内脏痛,位置多不很确定 但后壁慢性穿孔、急性穿孔、出血 ■■■■■■
一、症状 ⚫ 上腹痛：钝痛、灼痛、胀痛或剧痛，亦 有饥饿样不适感。 ⚫ DU患者约2/3 疼痛呈节律性，多为饥饿 性疼痛1/2呈夜间痛。（？） ⚫ GU患者也可发生规律性疼痛，但多为餐 后痛。偶有夜间痛。 ⚫ 溃疡痛是一种内脏痛，位置多不很确定。 但后壁慢性穿孔、急性穿孔、出血……
Clinical presentation o Duodenal ulceration is the most common and classically Presents with a history of periodic epigastric pain, often waking the patient at 1-3AM relived by food, milk or alkalis o Gastric ulcer pain may be epigastric or occur anywhere in the anterior upper abdomen
Clinical presentation ⚫ Duodenal ulceration is the most common and classically. Presents with a history of periodic epigastric pain, often waking the patient at 1-3AM relived by food, milk or alkalis. ⚫ Gastric ulcer pain may be epigastric or occur anywhere in the anterior upper abdomen