穿孔性胃潰瘍疾病是以前未知的多發性骨髓瘤和形細胞貧血的初始呈現
Matthew Ross Gowell1, Ahrin Anna Morrow2
1General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK matthew.gowell@live.co.uk.
BMJ case reports
|February 17, 2025
概括
一个罕见的穿孔性胃潰瘍病 (PUD) 病例导致了多发性骨髓瘤和状细胞病 (SCD) 的新诊断. 这突出了复杂患者中不典型的PUD原因.
科学领域:
- 胃肠病学 胃肠病学
- 血液学 血液学 血液学
- 内部医学 内部医学
背景情况:
- 胃潰瘍疾病 (PUD) 通常會引起腹痛,並可能呈現為胃腸穿孔.
- 患有复杂并发症的患者会带来诊断挑战,特别是当PUD是最初的表现时.
- 多发性骨髓瘤和状细胞病 (SCD) 是罕见的共诊断,呈现出穿孔PUD.
研究的目的:
- 报告一个异常罕见的穿孔性胃潰瘍疾病 (PUD) 病例.
- 突出PUD与新诊断的多发性骨髓瘤和状细胞病 (SCD) 的同时发生.
- 讨论多发性骨髓瘤和SCD患者PUD潜在的非典型病理生理机制.
主要方法:
- 病例报告详细介绍患者的介绍,诊断工作和治疗.
- 手术修复后组织的组织学分析 (补丁).
- 关于PUD在多发性骨髓瘤和SCD的文献综述.
主要成果:
- 穿孔性胃病 (PUD) 是导致多发性骨髓瘤和状细胞病 (SCD) 诊断的最初表现.
- 组织组织组织学没有显示出外骨髓瘤或粉样轻链沉积.
- 一个拟议的机制涉及恶性高热血症诱导的胃酸过分泌和与SCD相关的粘膜缺血症.
结论:
- 这一案例凸显了多种并发症患者的诊断复杂性.
- 在患有多发性骨髓瘤和状细胞病 (SCD) 的患者中,应考虑性病 (PUD) 的非典型原因.
- 恶性高血症和与状细胞疾病相关的缺血是这种独特患者队列中PUD的潜在贡献者.
相关概念视频
01:30Peptic Ulcer Disease I: Introduction
119
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
119
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
79
01:28Peptic Ulcer Disease II: Pathophysiology
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Peptic Ulcer Disease (PUD) is characterized by the development of ulcers in the stomach or duodenal mucosa. Its pathophysiology is complex, involving a balance between damaging and protective elements.
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.
223
01:22Esophageal Perforation-I: Introduction
56
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
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01:26Peptic Ulcer Disease IV: Management
60
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
60
01:22Pathophysiology of Peptic Ulcer Disease: Injurious Factors
524
Peptic ulcers are sores on the stomach's inner lining and the upper small intestine, which are the result of disruptions in the mucosal layer that houses parietal cells which produce gastric acid, and chief cells which secrete pepsinogen.
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
524