Curling's ulcer explained

Curling's ulcer
Field:General surgery, Gastroenterology
Synonyms:Curling ulcer

Curling's ulcer is an acute gastric erosion resulting as a complication from severe burns when reduced plasma volume leads to ischemia and cell necrosis (sloughing) of the gastric mucosa. The condition was first described in 1823 and named after Thomas Blizard Curling, who observed ten such patients in 1842.[1] [2]

These stress ulcers (actually shallow multiple erosions) were once a common complication of serious burns, presenting in over 10% of cases, and especially common in child burn victims.[3] They result in perforation and hemorrhage more often than other forms of intestinal ulceration[4] and had correspondingly high mortality rates (at least 80%).[5]

Treatment

While emergency surgery was once the only treatment, combination therapies including enteral feeding with powerful antacids such as H2-receptor antagonists or, more recently, proton pump inhibitors such as omeprazole have made Curling's ulcer a rare complication.[6]

See also

Notes and References

  1. Pruitt, Basil A. Jr. . F.D. Foley . John A. Moncrief . amp . Curling's ulcer: a clinical-pathology study of 323 cases . Annals of Surgery . 172 . October 1970 . 5311720 . 4 . 523–39 . 1397279 . 10.1097/00000658-197010000-00001.
  2. Curling, T. B.. On acute ulceration of the duodenum, in cases of burn. Medico-Chirurgical Transactions. 1842. 25. 260–281.
  3. Bruck, H.M. . Basil A. Pruitt Jr. . Curling's ulcer in children: a 12-year review of 63 cases . Journal of Trauma . 12 . June 1972 . 5033495 . 6 . 490–6 . 10.1097/00005373-197206000-00006.
  4. Lev R. . Letter: Stress erosions . Am J Dig Dis . 18 . 12 . 1099–100 . December 1973 . 4543410 . 10.1007/BF01076530 . Klein . Martin S. . Ennis . Frank . Sherlock . Paul . Winawer . Sidney J. .
  5. Book: Pedro-Pons, Agustín . Spanish . Patología y Clínica Médicas . 3rd . Salvat . Barcelona . 1968 . 6 . 1198 . 84-345-1106-1 .
  6. Moran KT, O'Reilly T, Munster AM . A combined regimen for the prophylaxis of Curling's ulcer . Am Surg . 53 . 10 . 575–6 . October 1987 . 2890321 .