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Hospital therapy. Diagnosis of gastric ulcer (most important)

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42. Diagnosis of gastric ulcer

Diagnostics. In the uncomplicated course of peptic ulcer, there are no changes in the general blood test, some decrease in ESR, slight erythrocytosis are possible. With the addition of complications, anemia appears in blood tests, leukocytosis - when the peritoneum is involved in the pathological process.

There are no changes in the general analysis of urine.

The traditional method of research in the pathology of the stomach is the determination of the acidity of gastric contents. Various indicators are possible: elevated and normal, in some cases even reduced. A duodenal ulcer occurs with high acidity of gastric juice.

In X-ray examination, a peptic ulcer is a "niche" - a depot of barium suspension.

Gastroduodenoscopy with biopsy is the most reliable method for diagnosing peptic ulcer. It allows you to assess the nature of changes in the mucous membrane in the edge of the ulcer, in the periulcerous zone and guarantees the accuracy of the diagnosis at the morphological level.

In endoscopic and morphological studies, it was found that most stomach ulcers are located in the area of ​​the lesser curvature and antrum, much less often - on the greater curvature and in the area of ​​the pyloric canal. 90% of duodenal ulcers are located in the bulbar region.

A morphological study of a biopsy specimen obtained from the bottom and edges of the ulcer reveals cellular detritus in the form of an accumulation of mucus with an admixture of decaying leukocytes, erythrocytes and desquamated epithelial cells with collagen fibers located underneath.

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