Pilor Kanalı Ülserleri Literatürün Gözden Geçirilmesi ve Onbeş Yeni Vak'anın Klinik Analizi

Year 1964, Volume: 17 Issue: 1, 61 - 76, 31.03.1964

Hamdi Aktan

Abstract

Bu makalede, pilor kanal ülserleriyle ilgili tıbbi literatür kapsamlı bir şekilde incelenmiş ve 15 kanal ülseri olgusu sunulmuştur.
Ankara Üniversitesi Gastroenteroloji Anabilim Dalı'nda peptik ülserler arasında pilor kanal ülseri görülme sıklığı %3,84 olarak bulunmuştur. Bu seri klinik ve radyolojik kriterlere göre derlenmiş olsa da, bir olguda ülser fiberskop ile görüntülenmiş, diğer üç olguda ise lezyonun pilordaki yeri cerrahi olarak da kanıtlanmıştır.
Kanal ülserleri için tanısal olduğu düşünülen "atipik ağrı - kusma - kilo kaybı" üçlüsü tartışılmıştır.
Bu durumun, hekimi nadiren pilor kanal ülseri tanısına götürebileceğini düşünüyoruz, ancak mevcut serilerin yarısından fazlasında klinik tablo yukarıda belirtilen semptom kompleksini içermektedir. Pilor kanal ülserlerinin tedavisinde genel kanı cerrahiyi desteklemektedir, ancak bizim olgularımızda tıbbi tedaviden elde ettiğimiz sonuçlar genellikle daha tatmin edicidir. Ancak, pilor tıkanıklığı komplikasyonu kanal ülserlerinde, başka yerlerdekilere kıyasla daha yaygın olduğundan, bu serideki on beş olgudan üçünde cerrahi müdahale gerekmiştir.

Keywords

Pyloric kanal ülseri , Peptik ülser , Atipik ağrı

Pyloric Canal Ulcers: Review of the Literature and Clinical Analysis of Fifteen New Cases

Abstract

In this article the medical literature concerning pyloric channel
ulcers have been thoroughly reviewed and a group of 15 cases
of canal ulcer have been presented.
The incidence of pyloric canal ulcer among peptic ulcers was
found to be 3.84 per cent in the Department of Gastroenterology,
University of Ankara. Although this series were collected according
to clinical - radiological criteria, in one case the ulcer was visualized
by fiberscope, and in three others pyloric location of the lesion was
also proven surgicaliy.
The triad of «Atypical pain - vomiting - weight loss» which
was considered to be diagnostic for canal ulcers has been discussed.
We feel that this may only rarely lead the physician to a diagnosis
of pyloric channel ulcer, although clinical picture in more than half
of present series included aforementioned symptom complex.
Although general opinion favors surgery in the management of
pyloric channel ulcers, the results that we have obtained from the
medical treatment in our cases are generally more satisfactory. However
since the complication of pyloric obstruction is more prevalent
among canal ulcers compared with those which are located elsewhere,
three out of fifteen cases in this series reguired surgery.

Keywords

Pyloric channel ulcer , Peptic ulcer , Atypical pain

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