Giant gastric and duodenal ulcers (>2-3 cm in greatest dimension) are reported to have higher rates of complication and mortality and to be associated with increasing age, renal failure, and use of nonsteroidal antiinflammatory drugs (NSAIDs).
This study investigated the outcome and associations of gastric and duodenal ulcers>2.5 cm compared to ulcers of lesser size.
Records from all patients with gastric and duodenal ulcers>0.5 cm diagnosed by upper endoscopy between January 1994 and September 1995 were studied for evidence of concurrent use of aspirin, NSAIDs, methamphetamine, and cocaine, as well as for transfusion requirements, length of hospital stay, mortality, surgery, rebleeding, Helicobacter pylori infection, and malignancy.
A logistic regression analysis of the 220 patients identified revealed that recent methamphetamine and/or cocaine use was significantly predictive of giant ulcer formation (p=0.0002) with an odds ratio of 9.66.
Also significant was younger age (p=0.026) and aspirin or NSAID use (p=0.046).
H. pylori infection was significant only for giant gastric ulcers (p=0.031).
Ulcer size did not predict mortality, rate of rebleeding, requirement for surgery, transfusion requirements, or length of hospital stay.
However, giant gastric ulcers were significantly more likely to be malignant (p=0.002).
Giant gastric and duodenal ulcers were strongly associated with stimulant abuse. (...)
Mots-clés Pascal : Ulcère, Estomac, Duodénum, Grande dimension, Facteur risque, Association morbide, Carcinome, Gastrite, Campylobactériose, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Cocaïne, Amphétamine(2,5-diméthoxy-4-méthyl), Antiinflammatoire non stéroïde, Epidémiologie, Homme, Appareil digestif pathologie, Estomac pathologie, Duodénum pathologie, Intestin pathologie, Tumeur maligne
Mots-clés Pascal anglais : Ulcer, Stomach, Duodenum, Large dimension, Risk factor, Concomitant disease, Carcinoma, Gastritis, Campylobacter infection, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Cocaine, Non steroidal antiinflammatory agent, Epidemiology, Human, Digestive diseases, Gastric disease, Duodenal disease, Intestinal disease, Malignant tumor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0071532
Code Inist : 002B13B03. Création : 21/05/1997.