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تمييز القرحة المعدية السليمة من الخبيثة !


تمييز القرحة المعدية السليمة من الخبيثة !

المعلومة

Gastic Acid Analysis may help distinguish benign from malignant gastric ulcers.

القرحة الحميدة ---> نادراً ما تترافق مع اللاهيدروكلورية Achlorhydria
القرحة الخبيثة ---> تترافق غالباً مع اللاهيدروكلورية Achlorhydria
أكثر أنواع القرحات خباثة ---> افراز حمضي طبيعي normal acid secretion

المرجع

NMS MEDICINE

by


شكرا

butterfly86's picture
butterfly86
بعد التخرج


There is only one way to reliably differentiate the two types of ulcers:That is Biopsy.
Now even when the gastric biopsies come back as nonmalignant it is important to repeat endoscopy after 3 months to confirm successful treatment. Any ulcer that does not respond to treatment should be suspected to have malignancy.
I don't disagree with what mentioned above but we don't depend on measuring gastric PH to determine if the ulcer benign of malignant

ABIM's picture
ABIM


thanx dr.Omar....but i have a question....can barium studies help us to differentiate between the tow types?

Fouad's picture
Fouad
بعد التخرج


If you go to radiology textbood you may find pages of pictures and discriptions for benign vs malignant ulcer .However all these signs lack sensitivity and specificity. The era of realying only on imaging and barium for diagnosis and treatment of benign or malignant ulcers is past.
Every gastric ulcer (esp if more than 5 mm) should be regarded as possibly malignant unless
1- Biopsies come back negative
2- Follow up endoscopy shows clearance of ulcer on treatment

ABIM's picture
ABIM


If you go to radiology textbood you may find pages of pictures and discriptions for benign vs malignant ulcer .However all these signs lack sensitivity and specificity. The era of realying only on imaging and barium for diagnosis and treatment of benign or malignant ulcers is past.
Every gastric ulcer (esp if more than 5 mm) should be regarded as possibly malignant unless
1- Biopsies come back negative
2- Follow up endoscopy shows clearance of ulcer on treatment

ABIM's picture
ABIM


شكرا لكم جميعا ....

qusei


شكرا لكم جميعا ....

qusei
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