What is a Bleeding Ulcer?

Stress ulceration and bleeding refers to acute hemorrhagic mucosal erosions of the esophagus, stomach, and duodenum (also known as Curling's ulcer) and bleeding after severe head injury.

Stress ulcer bleeding

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Stress ulceration and bleeding refers to acute hemorrhagic mucosal erosions of the esophagus, stomach, and duodenum (also known as Curling's ulcer) and bleeding after severe head injury.

Chinese name

Stress ulcer bleeding

Foreign name

stress ulceration and bleeding

Content

Esophageal bleeding after severe head injury

Clinical manifestation

Major gastrointestinal bleeding or perforation

The ulcer lesions are often multiple, irregular in shape, large in scope and superficial. The site of erosion ulcers can range from the esophagus, stomach to duodenum, but the gastric antrum is generally not affected. Most only involve the mucosa, and rarely exceed the muscularis mucosa. The above characteristics are significantly different from peptic ulcers. In addition to severe craniocerebral injury, this stress ulcer bleeding can also be seen in other severe trauma (including burns), major surgery, and systemic suppurative infections, chronic hypotension, shock, chronic failure and other chronically severe patients, It can be seen in people taking salicylic acid preparations, acute alcoholism, and large or long-term use of adrenal corticosteroids. The mechanism of its occurrence is not completely clear, and may be related to many factors. It is now believed to be mainly related to the excitement of parasympathetic nerves after severe injury. In the past, its incidence was not considered to be high. Since the widespread use of fiber gastroduodenoscopy, its discovery rate is not uncommon. Some people think that it accounts for 20% to 25% of upper gastrointestinal bleeding for various reasons. The clinical manifestations are characterized by sudden upper gastrointestinal bleeding or perforation in the wounded without prior symptoms and no history of peptic ulcer, but the bleeding is far more common than perforation. Hemorrhage was not accompanied by abdominal pain, and was mostly intermittent. The first bleeding usually occurred a few days after the trauma. Once stress ulcer bleeding occurs, the mortality rate can reach more than 50%, and the death is due to acute hemorrhagic shock.

Lesions similar to the above-mentioned stress ulcer bleeding can also be found in the hypothalamus and adrenal glands (Hua-Fond syndrome).