Curling's ulcer

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Curling's ulcer
Classification and external resources
DiseasesDB 3237
MeSH D004381
[edit on Wikidata]

Curling's ulcer (stress ulcer) or a Curling ulcer is an acute gastric erosion 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][2]

These stress ulcers (actually shallow multiple erosions) were once a common complication of serious burns, presenting in over 10% of cases,[1] and especially common in child burn victims.[3] They result in perforation and hemorrhage more often than other forms of intestinal ulceration[4] and had correspondingly high mortality rates (at least 80%).[1][5]

A similar condition involving elevated intracranial pressure is known as Cushing's ulcer.

Treatment

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.[6]

References

  1. ^ a b c Pruitt, Basil A. Jr.; F.D. Foley & 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 1397279Freely accessible. PMID 5311720. 
  2. ^ Curling, T. B. (1842). "On acute ulceration of the duodenum, in cases of burn". Medico-Chirurgical Transactions. 25: 260–281. 
  3. ^ Bruck, H.M.; 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. 
  4. ^ 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. 
  5. ^ Pedro-Pons, Agustín (1968). Patología y Clínica Médicas (in Spanish). 6 (3rd ed.). Barcelona: Salvat. p. 1198. ISBN 84-345-1106-1. 
  6. ^ 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. 
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