Intractable upper gastrointestinal ulceration due to aspirin in patients who have undergone surgery for peptic ulcer

Gastroenterology
B I Hirschowitz, A Lanas

Abstract

Postsurgical ulcer recurrence is a challenging problem. The aim of this study was to define the role of aspirin in postsurgical ulcers. We studied 30 patients with postsurgical ulcer and aspirin abuse. Preoperatively 13 had stenosis, 7 bleeding, and 7 perforation or penetration; 18 had undergone vagotomy and 11 gastrectomy. Of 30 patients, 15 admitted long-term aspirin use (1-4 g/day), whereas 15 denied use but had positive salicylate blood levels (15.1 +/- 2.25 mg/100 mL; >1 mmol/L). Gastrin or gastric secretion was normal in the 24 patients tested. On follow-up, 3 (10%) healed after surgery (all stopped taking aspirin), whereas 27 continued and had new ulcers; 12 (44%) developed stenosis, and 6 (23%) developed bleeding. A second operation was required in 16 patients who had continued aspirin abuse, which was surreptitious in 10 (63%). Thirteen of these 16 had recurrent ulceration (7 [43%] with stenosis and 1 with bleeding); 1 died and 2 stopped taking aspirin and healed. A third operation was required in 8 patients. All had continued aspirin abuse (75% surreptitiously), and all again had relapses (3 with stenosis); 1 underwent an unsuccessful fourth operation, and 3 died. With continued aspirin abuse, recurrent ulceration is ...Continue Reading

Citations

Feb 13, 2001·The American Journal of Medicine·B I Hirschowitz, C J Hawkey
Feb 6, 2002·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·A Lanas
Oct 22, 2003·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·B I Hirschowitz
Oct 7, 2006·Current Opinion in Gastroenterology·R C MoesingerJ W Harmon
Apr 18, 2002·Journal of Clinical Gastroenterology·Basil I Hirschowitz, Angel Lanas
Aug 12, 2014·Diagnostic and Therapeutic Endoscopy·Neal ShahidiRobert Enns
Sep 12, 2015·The Korean Journal of Internal Medicine·Chen-Shuan ChungYi-Chia Lee
Aug 27, 2009·Alimentary Pharmacology & Therapeutics·J P Gisbert, X Calvet
Apr 5, 2000·Baillière's Best Practice & Research. Clinical Gastroenterology·P MalfertheinerU Peitz
Dec 21, 2002·The American Journal of Gastroenterology·Mihnea V ChioreanL Joseph Melton
Feb 24, 2000·The American Journal of Gastroenterology·A LanasB I Hirschowitz
Jul 1, 2005·Current Problems in Surgery·Sean P Harbison, Daniel T Dempsey
Jul 17, 2004·European Journal of Gastroenterology & Hepatology·Nicolaas L A ArentsJan H Kleibeuker
Mar 8, 2006·World Journal of Gastroenterology : WJG·Konstantinos DemertzisSpiros D Ladas

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