Related Experiment Video
Updated: Jun 21, 2026

Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
Published on: April 28, 2026
[Gastric perforation associated with Candida infection]
Jesús Bollo1, Elena Carrilo, Ion Lupu
1Servicio de Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España. JBollo@santpau.es
Abstract:
Notable causes of gastroduodenal ulcer are Helicobacter pylori infection, intake of non-steroidal anti-inflammatory agents, neoplastic disease, acid hypersecretory states and secondary peptic ulcer disease. There are case reports of healthy patients or those with risk factors for fungal infection who develop gastroduodenal ulcer perforation associated with the presence of fungi in ascitic fluid or gastroduodenal ulcer tissue but without the above-mentioned etiological factors. Thus, other factors and pathogens may be involved in the pathogenesis of perforation. The use of antifungal agents in patients following surgery for a perforated gastroduodenal ulcer is controversial. We report two cases of healthy patients who underwent surgery for perforated gastroduodenal ulcer, in whom the most frequent causes of perforation were excluded. Only the presence of Candida in the ulcer was found.
Insights
Fungal infections, specifically Candida, may cause gastroduodenal ulcers in healthy individuals. This challenges traditional understanding and suggests a need for antifungal consideration in perforated ulcer cases.
Area of Science:
- Gastroenterology
- Mycology
- Infectious Diseases
Background:
- Common causes of gastroduodenal ulcers include Helicobacter pylori, NSAIDs, and malignancy.
- Fungal presence in gastroduodenal ulcers has been reported, but often in patients with risk factors or other etiological factors.
Observation:
- Two healthy patients underwent surgery for perforated gastroduodenal ulcers.
- Standard causes for perforation were excluded in both cases.
- Candida was identified in the ulcer tissue of both patients.
Findings:
- The presence of Candida in gastroduodenal ulcers may be an independent etiological factor for perforation, even in healthy individuals.
- This finding suggests that fungal pathogens can play a role in gastroduodenal ulcer pathogenesis.
Implications:
- The role of antifungal agents in managing perforated gastroduodenal ulcers warrants further investigation.
- Clinicians should consider fungal infections as a potential cause of gastroduodenal ulcer perforation, particularly when common causes are absent.
Related Concept Videos
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Candidiasis
Peptic Ulcer
Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Gastritis II: Pathophysiology
