RESUMO
Upper endoscopic and gastric acid output studies were done in 51 patients with homozygous sickle cell (SS) disease and recurrent epigastric pain. Twenty (39 percent) had abnormalities in the upper gastrointestinal tract including 18 (35 percent) with peptic ulcers. Mean bassal and maximum acid output were similar in patients with and without duodenal ulcer (DU). Because DU in SS disease does not appear to be associated with high acid outputs observed in other populations, it may reflect reduced mucosal resistance, possibly resulting from ischaemia. This hypothesis was supported by the significantly lower fetal haemoglobin level among SS-DU patients. (Summary)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Abdome , Anemia Falciforme/complicações , Ácido Gástrico/metabolismo , Dor/etiologia , Úlcera Péptica/complicações , Anemia Falciforme/metabolismo , Anemia Falciforme/fisiopatologia , Duodenoscopia , Gastroscopia , Úlcera Péptica/fisiopatologiaRESUMO
Patients with homozygous sickle-cell disease frequently experience recurrent upper abdominal pain, the cause of which usually remains unknown. In order to determine the frequency of peptic ulcer disease, upper endoscopic and gastric acid studies were performed in 51 patients with homozygous sickle-cell (SS) disease and recurrent epigastric pain. Twenty (39 percent) had abnormalities in the upper gastrointestinal tract of which 18 (35 percent) had peptic ulcers. The clinical features were similar between patients with ulcers and those with a normal upper gastrointestinal tract. Mean basal and maximum acid output were similar in patients with and those without a duodenal ulcer (DU). Acid output in 15 haematologically normal patients with DU was significantly greater than in those with sickle-cell disease. Since duodenal ulceration in SS disease does not appear to be associated with the high acid output observed in other populations, it may reflect reduced mucosal resistance; this could result from ischaemia. This hypothesis was supported by finding significantly lower foetal haemoglobin levels in SS-DU patients (3.6 percent) than in SS controls (5.7 percent) (AU)
Assuntos
Humanos , Anemia Falciforme/complicações , Ácido Gástrico/metabolismo , Úlcera Péptica/etiologia , JamaicaRESUMO
The augmented histamine test (AHT) and the Hollander single criterion test have been carried out in patients who have been treated with highly selective vagotomy (HSV) for chronic duodenal ulcer. The HSV reduced basal acid output and maximum acid output by 50 to 70 percent at eight days after the operation comparedwith pre-operative levels. This reduction was maintained at three months. The Hollander test indicated that the vagotomy was inadequate in nineteen out of twenty patients (AU)
