Helicobacter pylori and peptic ulcer disease. Reexamining the therapeutic approach.

Now that Helicobacter pylori has been strongly implicated as a causative factor in peptic ulcer disease, the dictum "no acid--no ulcer" may no longer be valid. However, H pylori has proved difficult to eradicate, and the approach to treatment of peptic ulcer is undergoing changes. At present, a triple-drug combination of bismuth and antibiotics is advised, and cultures should be obtained before and after treatment to monitor its efficacy. Side effects include pseudomembranous colitis and drug resistance.

Partial deployment of the Garren gastric bubble: a new complication.

The Garren gastric bubble has recently been introduced as a new treatment for obesity. The technique entails endoscopic placement of a balloon intragastrically to help decrease hunger and cause the feeling of early satiety. Recently side effects and complications have been reported. This report describes a complication in which the balloon would not deploy from the introducer so it could not be removed or inflated. After multiple maneuvers, the gastric bubble was finally removed with no serious sequelae. It is possible if the balloon is loaded and passed without carefully aligning all the parts of the equipment that serious complications could result.

Liver disease caused by propylthiouracil.

This report presents the clinical, laboratory, and light and electron microscopic observations on a patient with chronic active (aggressive) hepatitis caused by the administration of propylthiouracil. This is an addition to the list of drugs that must be considered in the evaluation of chronic liver disease.