Curling's ulcer

Last updated
Curling's ulcer
Other namesCurling ulcer
Specialty General surgery, Gastroenterology

Curling's 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]

Contents

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.[ citation needed ]

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]

See also

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References

  1. 1 2 3 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   1397279 . 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). Vol. 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.