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Medical dictionaryulcer [ul´ser] a local defect, or excavation of the surface of an organ or tissue, produced by sloughing of necrotic inflammatory tissue. It usually remains for five to seven days and heals within two weeks with no scarring. Arterial and venous ulcers are quite different and require different modes of treatment.

Venous stasis ulcers occur as a result of venous insufficiency in the lower limb. The insufficiency is due to deep vein thrombosis and failure of the one- way valves that act during muscle contraction to prevent the backflow of blood. Chronic varicosities of the veins can also cause venous stasis. Patient Care. Stasis ulcers are difficult to treat because impaired blood flow interferes with the normal healing process and prolongs repair. Patient care is concerned with preventing a superimposed infection in the ulcer, increasing blood flow in the deeper veins, and decreasing pressure within the superficial veins. Marginal ulcers are a frequent complication of surgical treatment for peptic ulcer; they are difficult to control medically and often require further surgery. H+, and impaired cell proliferation.

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Hunner's ulcer  one involving all layers of the bladder wall, occurring in chronic interstitial cystitis. L. ulcus, sore, ulcer] A lesion of the skin or mucous membranes marked by inflammation, necrosis, and sloughing of damaged tissues. A wide variety of insults may produce ulcers, including trauma, caustic chemicals, intense heat or cold, arterial or venous stasis, cancers, drugs (such as nonsteroidal anti- inflammatory drugs [NSAIDs]), and infectious agents such as Herpes simplex or Helicobacter pylori.

An ulcer that destroys tissue to the bone by encircling the part. An ulcer of the oral mucosa, usually less than 0.

If it persists for longer than 2 weeks, it should be biopsied to rule out cancer. Synonym: aphthous stomatitis; canker sore See: illustration. Etiology. Aphthous ulcers are found in stomatitis, Behçet syndrome, Crohn disease, acquired immunodeficiency syndrome, and some cancers. Treatment. For patients with oral ulcers, application of a topical anesthetic or a protective paste provides symptomatic relief and makes it possible to eat without pain. Ischemic ulcer. atonic ulcer.

A chronic ulcer with little tendency to heal. Buruli ulcer. An infection of the skin and underlying tissues with Mycobacterium ulcerans. The infection, common in the tropics and subtropics, develops slowly from a painless or minimally painful nodule on the skin into underlying bone, which it gradually destroys.

The spread of the disease may be prevented with bacille Calmette- Guérin (BCG) vaccine. A chronic, slowly healing ulcer with indurated, elevated edges but no granulation. Cameron ulcer See: Cameron ulcerchiclero ulcer. A Central American term for cutaneous leishmaniasis. Any long- standing, slowly healing ulcer of a lower extremity, esp.

Curling ulcer See: Curling ulcer. Cushing ulcer See: Cushing, Harveydecubitus ulcer. Pressure ulcerdenture ulcer. An ulcer of the oral mucosa caused by irritation from wearing dentures. Patient care. To prevent irritation and ulceration of the mucous membranes of the mouth, denture wearers should clean dentures daily and remove them while sleeping. Poorly fitting dentures should be reconstructed or padded by a denturist. Diabetic foot infection.

An open sore on the mucosa of the first portion of the duodenum, most often the result of infection with Helicobacter pylori. It is the most common form of peptic ulcer. See: peptic ulcerfollicular ulcer.

A tiny ulcer originating in a lymph follicle and affecting a mucous membrane. An ulcer in which the granulations protrude above the edges of the wound and bleed easily. An ulcer caused by a fungus. An ulcer of the gastric mucosa. Etiology. Common causes are NSAIDs, use of alcohol or tobacco, and infection with H. See: peptic ulcer. Hunner ulcer. Interstitial cystitis.

A nearly painless ulcer usually found on the leg, characterized by an indurated, elevated edge and a nongranulating base. An ulcer caused by diminished blood flow through an artery, esp. These ulcers are usually found in patients with peripheral vascular disease. They may result in loss of digits as a result of gangrene. Synonym: arterial ulcer. Marjolin ulcer See: Marjolin ulcer.

Meleney ulcer See: Meleney ulcer. Mooren ulcer See: Mooren ulcerpeptic ulcer. An ulcer in the lining of the duodenum, the lower end of the esophagus, or the stomach (usually along the lesser curvature). Peptic ulcer disease is a common illness, affecting about 1. Curling ulcer; Helicobacter pylori; stress ulcer; Zollinger- Ellison syndrome; Etiology. Harry Brown Full Movie Part 1. Common causes of peptic ulcer are factors that increase gastric acid production or impair mucosal barrier protection, e.

NSAIDs, smoking, H. Ulcers occur in men and women and occur most frequently in patients over age 6. U. S. The relationship between peptic ulcer and emotional stress is not completely understood. Symptoms. Patients with peptic ulcers may be asymptomatic or have gnawing epigastric pain, esp.

At times, heartburn, nausea, vomiting, hematemesis, melena, or unexplained weight loss may signify peptic disease. Food intake often relieves the discomfort. Peptic ulcers that perforate the upper gastrointestinal tract may penetrate the pancreas, causing symptoms of pancreatitis (severe back pain) and chemical peritonitis followed by bacterial peritonitis or an acute abdomen as irritating gastrointestinal (GI) contents and bacteria enter the abdominal cavity. Bacterial peritonitis can lead to sepsis, shock, and death.

Diagnosis. Endoscopy (esophagogastroduodenoscopy) provides the single best test to diagnose peptic ulcers because it allows direct visualization of the mucosa and permits carbon–1. H. pylori and rule out cancer. During endoscopy, tissue can be excised, vessels ligated, or sclerosants injected.

Barium swallow or upper GI x- ray series may also be used to provide images for diagnosis or follow- up and may be the initial test for patients whose symptoms are not severe. Treatment. H. pylori causes most peptic ulcers in the duodenum; antibiotics (clarithromycin and amoxicillin) are prescribed to treat H. Bismuth or other coating agents may be used as a barrier to protect the duodenal mucosa.

Peptic ulceration of the stomach may be treated with the same medications if biopsies or breath tests reveal H. When patients have ulcers caused by the use of NSAIDs or tobacco, withholding these agents and treating with an H2 blocker, e. The prostaglandin analogue misoprostol may also be used to suppress or prevent peptic ulcer caused by use of NSAIDs. GI bleeding is managed initially with passage of a nasogastric tube and iced saline lavage, possibly with norepinephrine added.

Gastroscopy then allows visualization of the bleeding site and laser or cautery coagulation. When conservative medical treatment is ineffective, vagotomy and pyloroplasty may be used to reduce hydrochloric acid secretion and enlarge the pylorus to enhance gastric emptying.

More extreme surgical therapy (including subtotal gastric resection) may be needed in rare instances of uncontrollable hemorrhage or perforation occurring as a result of peptic ulcer disease. Patient care. The ambulatory patient is educated about agents that increase the risk for peptic ulceration and given specific instructions to avoid them. Instruction should include the importance of adhering to prescription drug therapies, adverse reactions to H2- receptor antagonists and omeprazole (dizziness, fatigue, rash, diarrhea), and the need for follow- up examination and care. For the hospitalized patient with ulcer- related bleeding, careful monitoring of vital signs, fluid balance, hemoglobin levels, and blood losses may enhance early recognition of worsening disease. Intravenous (IV) access is established, and IV opiates are administered as prescribed for pain control. The patient is kept nil per os (NPO).

Electrolytes and fluids are replaced as needed.