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Radiographic findings of intractable gastric ulcers with H2-receptor antagonists
M Okada1, T Shirotani, T Sakurai
1First Department of Internal Medicine, School of Medicine, Fukuoka University 45-1, 7-chome Nanakuma, Jonan-ku, Fukuoka, 814-01, Japan.
Background:
To clarify the radiographic characteristics of intractable gastric ulcers with H2-receptor antagonists.
Methods:
The radiographic findings at the time of starting treatment were compared between 42 patients with gastric ulcers that did not heal within eight weeks of starting treatment with H2-receptor antagonists (the intractable group) and 58 patients whose ulcers healed within the eight-week period (the tractable group).
Results:
The following radiographic findings in the intractable group were observed at a significantly higher incidence than those in the tractable group and included: an ulcer located on the angle, linear ulcers, a greater depth, an uneven mound surrounding an ulcer, prominent folds' convergence, an overhanging gastric mucosa, an irregular ulcer base, a shortening of the lesser curvature and a U-shaped deformity of the angle. A multiple logistic regression analysis showed that the following three factors had a significant and independent delaying effect on healing: a U-shaped deformity of the angle, an uneven mound surrounding an ulcer and prominent folds' convergence. The relative risk of these factors were 12.7, 14.4 and 12.5, respectively.
Conclusions:
Intractable gastric ulcer with H2-receptor antagonists can be predicted based on the characteristic radiographic findings at the start of treatment.