Curling's ulcer

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

Curling's ulcer or a Curling ulcer is an acute peptic ulcer of the duodenum resulting as a complication from severe burns when reduced plasma volume leads to ischemia and cell necrosis (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] It is also known an GI ulceration. 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[edit]

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[edit]

  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. doi:10.1097/00000658-197010000-00001. PMC 1397279. PMID 5311720. 
  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. doi:10.1097/00005373-197206000-00006. PMID 5033495. 
  3. ^ Lev R; Klein, Martin S.; Ennis, Frank; Sherlock, Paul; Winawer, Sidney J. (December 1973). "Letter: Stress erosions". Am J Dig Dis 18 (12): 1099–100. doi:10.1007/BF01076530. PMID 4543410. 
  4. ^ Moran KT, O'Reilly T, Munster AM (October 1987). "A combined regimen for the prophylaxis of Curling's ulcer". Am Surg 53 (10): 575–6. PMID 2890321.