Advertisement

Acute Stress Ulceration: Incidence and Prophylaxis

  • K. Hillman
Conference paper
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 1)

Abstract

Acute stress ulceration usually refers to a mucosal abnormality of the oesophagus, stomach or duodenum. It often occurs in seriously ill patients who have an acute pathophysiological disturbance, such as hypotension, hypoxia, sepsis, uraemia or ischaemia. The mucosal abnormalities range from hyperaemia to deep ulceration and occasionally perforation. Endoscopically verified mucosal erosions occur in all patients with multi-organ failure or sepsis [1]. Although the aetiology of stress ulceration is not completely understood, there are, at least, three important factors [2] (Table 1).

Keywords

Stress Ulceration Mucosal Blood Flow Gastric Mucosal Blood Flow Mucosal Abnormality Gastric Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Lucas CE, Sugawa MK, Riddle J, Rector F, Rosenberg B, Walt AJ (1971) Natural history and surgical dilemma of “stress” gastric bleeding. Arch Surg 102: 266–273PubMedCrossRefGoogle Scholar
  2. 2.
    Silen W, Merhav A, Simson JNL (1981) The pathophysiology of stress ulcer disease. World J Surg 5: 165–174PubMedCrossRefGoogle Scholar
  3. 3.
    Martin LF, Max MH, Polk HC (1980) Failure of gastric pH control by antacids or cimetidine in the critically ill: a valid sign of sepsis. Surgery 88: 59–68PubMedGoogle Scholar
  4. 4.
    Hillman KM (1985) Acute stress ulceration. Anaesth Intens Care 13: 230–240Google Scholar
  5. 5.
    Pingleton SK, Hadzima SK (1983) Enteral alimentation and gastrointestinal bleeding in mechanically ventilated patients. Crit Care Med 11: 13–16PubMedCrossRefGoogle Scholar
  6. 6.
    Hastings PR, Skillman JJ, Bushnell LS, Silen W (1978) Antacid titration in the prevention of acute gastrointestinal bleeding. N Engl J Med 298: 1041–1045PubMedCrossRefGoogle Scholar
  7. 7.
    Pinilla JC, Oleniuk FH, Reed D, Malik B, Laverty WH (1985) Does antacid prophylaxis prevent upper gastrointestinal bleeding in critically ill patients? Crit Care Med 13: 646–650PubMedCrossRefGoogle Scholar
  8. 8.
    Priebe HJ, Skillman JJ, Bushnell LS, Long PC, Silen W (1980) Antacid versus cimetidine in preventing acute gastrointestinal bleeding. A randomised trial in 75 critically ill patients. N Engl J Med 302: 426–430PubMedCrossRefGoogle Scholar
  9. 9.
    Marrone GO, Silen W (1984) Pathogenesis, diagnosis and treatment of acute gastric muco-sal lesion. Clin Gastroenterol 13: 635–650PubMedGoogle Scholar
  10. 10.
    Albin M, Friedlos J, Hillman KM (in press) Continuous intragastric pH measurement in the critically ill and treatment with parenteral ranitidine. Intens Care MedGoogle Scholar
  11. 11.
    MacDougall BRD, Bailey RI, Williams R (1977) H2-receptor antagonists and antacid in the prevention of acute gastro-intestinal hemorrhage in fulminant hepatic failure. Two controlled trials. Lancet i: 617–619Google Scholar
  12. 12.
    Croker JR (1979) Acute gastro-intestinal bleeding in the critically ill patient. Intens Care Med 5: 1–4CrossRefGoogle Scholar
  13. 13.
    Hillman KM, Riordan T, O’Farrell SM, Tabaqchali S (1982) Colonisation of the gastric contents in critically ill patients. Crit Care Med 10: 444–447PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • K. Hillman

There are no affiliations available

Personalised recommendations