Clinical Journal of Gastroenterology

, Volume 11, Issue 3, pp 251–256 | Cite as

Refractory gastric antral ulcers without Helicobacter pylori infection and non-steroidal anti-inflammatory drugs

  • Hirotada Nishie
  • Hiromi Kataoka
  • Hiroyuki Kato
  • Taketo Suzuki
  • Hiroshi Ichikawa
  • Yu Nojiri
  • Mika Kitagawa
  • Yusuke Inagaki
  • Hiroyasu Iwasaki
  • Mamoru Tanaka
  • Takahito Katano
  • Yasuyuki Okamoto
  • Keiji Ozeki
  • Tsutomu Mizoshita
  • Takaya Shimura
  • Eiji Kubota
  • Satoshi Tanida
  • Takashi Joh
Case Report
  • 80 Downloads

Abstract

Herein, we describe a rare case of refractory gastric antral ulcers. A woman in her 50 s was admitted to Nagoya City University Hospital with epigastric pain after being diagnosed with gastric antral submucosal tumor at another hospital. Findings from esophagogastroduodenoscopy and endoscopic ultrasound examination revealed that the lesion was a gastric ulcer. The patient had no Helicobacter pylori infection and no recent history of using non-steroidal anti-inflammatory drugs. On the basis of these findings, we diagnosed this as a case of refractory gastric antral ulcer (RGAU). RGAU is considered a new disease concept and detailed analyses are expected in the future.

Keywords

Refractory gastric antral ulcer (RGAU) Helicobacter pylori Non-steroidal anti-inflammatory drugs (NSAIDs) 

Notes

Compliance with ethical standards

Conflict of interest

Hirotada Nishie, Hiromi Kataoka, Hiroyuki Kato, Taketo Suzuki, Hiroshi Ichikawa, Yu Nojiri, Mika Kitagawa, Yusuke Inagaki, Hiroyasu Iwasaki, Mamoru Tanaka, Takahito Katano, Yasuyuki Okamoto, Keiji Ozeki, Tsutomu Mizoshita, Takaya Shimura, Eiji Kubota, Satoshi Tanida and Takashi Joh declare that they have no conflict of interest.

Human rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed consent

Informed consent was obtained from all patients to be included in the study.

References

  1. 1.
    Ciociola AA, McSorley DJ, Turner K, Sykes D, Palmer JB. Helicobacter pylori infection rates in duodenal ulcer patients in the United States may be lower than previously estimated. Am J Gastroenterol. 1999;94:1834–40.CrossRefPubMedGoogle Scholar
  2. 2.
    Kanno T, et al. Helicobacter pylori-negative and non-steroidal anti-inflammatory drugs-negative idiopathic peptic ulcers show refractoriness and high recurrence incidence: multicenter follow-up study of peptic ulcers in Japan. Dig Endosc. 2016;28:556–63.CrossRefPubMedGoogle Scholar
  3. 3.
    Yamane T, et al. Refractory gastric antral ulcer of unknown etiology. Diges Endosc. 2008;20:203–6.CrossRefGoogle Scholar
  4. 4.
    Malfertheiner P, Chan FK, McColl KE. Peptic ulcer disease. Lancet. 2009;374:1449–61.CrossRefPubMedGoogle Scholar
  5. 5.
    Yamane T, Umeda A, Shimao H, Ishii T. A Case of refractory gastric cardia ulcer in which marked elevation of the surrounding mucosa was observed during the clinical course. Gastroenterol Res. 2013;6:106–9.Google Scholar
  6. 6.
    Iijima K, Kanno T, Koike T, Shimosegawa T. Helicobacter pylori-negative, non-steroidal anti-inflammatory drug: negative idiopathic ulcers in Asia. World J Gastroenterol. 2014;20:706–13.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Chung CS, Chiang TH, Lee YC. A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers. Korean J Intern Med. 2015;30:559–70.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Huang JQ, Sridhar S, Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. Lancet. 2002;359:14–22.CrossRefPubMedGoogle Scholar
  9. 9.
    Bento-Miranda M, Figueiredo C. Helicobacter heilmannii sensu lato: an overview of the infection in humans. World J Gastroenterol. 2014;20:17779–87.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Goji S, et al. Helicobacter suis-infected nodular gastritis and a review of diagnostic sensitivity for Helicobacter heilmannii-like organisms. Case Rep Gastroenterol. 2015;9:179–87.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Meucci G, et al. Prevalence and risk factors of Helicobacter pylori-negative peptic ulcer: a multicenter study. J Clin Gastroenterol. 2000;31:42–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Iijima K, et al. Preferential location of idiopathic peptic ulcers. Scand J Gastroenterol. 2016;51:782–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Hung LC, et al. Long-term outcome of Helicobacter pylori-negative idiopathic bleeding ulcers: a prospective cohort study. Gastroenterology. 2005;128:1845–50.CrossRefPubMedGoogle Scholar
  14. 14.
    Wong GL, et al. High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers. Gastroenterology. 2009;137:525–31.CrossRefPubMedGoogle Scholar
  15. 15.
    Kanno T, et al. A multicenter prospective study on the prevalence of Helicobacter pylori-negative and nonsteroidal anti-inflammatory drugs-negative idiopathic peptic ulcers in Japan. J Gastroenterol Hepatol. 2015;30:842–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Yamane T, Ishii T, Umeda A, Shimao H. Evaluation of six cases of idiopathic gastric antral ulcer. Gastroenterol Res. 2012;5:120–6.Google Scholar

Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Hirotada Nishie
    • 1
  • Hiromi Kataoka
    • 1
  • Hiroyuki Kato
    • 2
  • Taketo Suzuki
    • 1
  • Hiroshi Ichikawa
    • 1
  • Yu Nojiri
    • 1
  • Mika Kitagawa
    • 1
  • Yusuke Inagaki
    • 1
  • Hiroyasu Iwasaki
    • 1
  • Mamoru Tanaka
    • 1
  • Takahito Katano
    • 1
  • Yasuyuki Okamoto
    • 1
  • Keiji Ozeki
    • 1
  • Tsutomu Mizoshita
    • 1
  • Takaya Shimura
    • 1
  • Eiji Kubota
    • 1
  • Satoshi Tanida
    • 1
  • Takashi Joh
    • 1
  1. 1.Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
  2. 2.Department of Experimental Pathology and Tumor BiologyNagoya City University Graduate School of Medical SciencesNagoyaJapan

Personalised recommendations