[Bleeding of gastric ulcers. Epidemiologic, clinical and functional characteristics]. / Il sanguinamento da ulcera gastrica. Caratteristiche epidemiologiche, cliniche e funzionali.

The frequency of gastrointestinal haemorrhage due to gastric ulcer has been assessed in 254 personally observed patients suffering from this endoscopically verified pathology. 56 patients, namely 22% of the cases, presented haematemesis and/or melena of the ulcerative lesion. This subgroup was compared with 65 patients with endoscopically verified gastric ulcer without previous bleeding episodes from the lesion in their clinical history, in respect of certain epidemiological, clinical and biohumoral features. The purpose of the study was to check the possible existence of clinical and/or physiopathological differences between subjects with bleeding gastric ulcer and the population of non-bleeding ulcer patients. In 80% of patients studied, the gastric ulcerous disease started with digestive haemorrhage and it was not accompanied by dyspeptic-painful symptomatology in 20% of cases. The pain symptomatology does not appear to be influenced by the intake of non-steroid anti-phlogistic drugs. No significant difference emerges between the two groups considered as regards epidemiological features and biohumoral data (PG I, gastrin, B.A.O. and M.A.O.).

Gastric and duodenal ulcer in the same patient.

UNLABELLED: No extensive endoscopic studies have been performed on the prevalence and the clinical outcome of association of gastric ulcer (GU) and duodenal ulcer (DU). The present investigation, partially retrospective and partially prospective, takes into account 715 patients with active ulcer demonstrated by endoscopy, followed-up for a mean period of 3.8-years; 23 of them (3.2%) were found to have synchronous or asynchronous gastric and duodenal ulcers. The following characteristics were investigated: age of onset of both diseases, ulcer family history, cigarette and alcohol consumption, nonsteroidal anti-inflammatory drugs abuse, serum pepsinogen group I, ABO and Lewis blood groups, healing and relapse rate under H2-blocker treatment. The first diagnosis (by either X-Ray or endoscopy) was DU in 500 subjects (70%), GU in 210 (29.3%) and synchronous gastric and duodenal ulcers in 5 (0.7%). After a median period of 10 years, 2.8% of DU patients developed a GU; after 2-12 yrs 1.9% of GU patients developed a DU. The clinical and biochemical findings of our GU/DU patients suggest that the two ulcers are related by chance. IN CONCLUSION: asynchronous GU/DU patients do not seem to have a distinct disease in the large spectrum of ulcer disease. Larger studies must be planned on synchronous GU/DU with the aim of assessing whether or not it represents a particular type of ulcer disease.