Curling's ulcer


Curling's ulcer
Curling's ulcer
Classification and external resources
DiseasesDB 3237
MeSH D004381

Curling's ulcer is an acute peptic ulcer of the duodenum resulting as a complication from severe burns when reduced plasma volume leads to sloughing of the gastric mucosa. The condition was first described in 1823 and named for a doctor, Thomas Blizard Curling, who observed ten such patients in 1842.[1]

These stress ulcers were once a common complication of serious burns, presenting in over 10% of cases,[1] and especially common in child burn victims.[2] They result in perforation and hemorrhage more often than other forms of intestinal ulceration[3] and had correspondingly high mortality rates.[1]

A similar condition involving elevated intracranial pressure is known as Cushing's ulcer.

Treatment

While emergency surgery was once the only treatment, combination therapies including enteral feeding with powerful antacids such as H2-receptor antagonists or, more recently, proton pump inhibitors such as omeprazole have made Curling's ulcer a rare complication.[4]

References

  1. ^ a b c Pruitt, Basil A., Jr., F.D. Foley and John A. Moncrief (October 1970). "Curling's Ulcer:A Clinical-Pathology Study of 323 Cases". Annals of Surgery 172 (4): 523–39. PMC 1397279. PMID 5311720. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1397279. 
  2. ^ Bruck, H.M. and Basil A. Pruitt, Jr. (June 1972). "Curling's ulcer in children: a 12-year review of 63 cases". Journal of Trauma 12 (6): 490–6. PMID 5033495. 
  3. ^ Lev, Robert et al. (December 1973). "Stress erosions". Digestive Diseases and Sciences 18. 
  4. ^ Moran, K.T., T. O'Reilly and A.M. Munster (October 1987). "A combined regimen for the prophylaxis of Curling's ulcer". American Surgeons 53. 

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