Cushing Ulcers Minoru Kawaguchi 1 1Department of Internal Medicine, International University of Health and Welfare, Atami Hospital Keyword: Cushing潰瘍 , 中枢神経障害 , ストレス潰瘍 , 急性胃十二指腸粘膜病変 , 内視鏡的止血法 pp.501-505
Published Date 2003/4/24
DOI https://doi.org/10.11477/mf.1403100906
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 Since 1932, when Cushing first reported on esophagogastroduodenal ulcers following brain-tumor surgery, gastrointestinal lesions accompanying central nervous system disorders have been referred to as Cushing ulcers.

 A Cushing ulcer is classified as an acute gastroduodenal mucosal lesion and is a type of stress ulcer.

 As for its onset mechanism, a disorder of the central nervous system stimulates the parasympathetic system and induces vagotonia, and due to the subsequent mucosal circulation disorder and increased acid secretion, ulceration occurs. However, many other factors are also involved and interact in a complicated manner.

 The incidence of Cushing ulcers ranges widely, from 10% to 70%, and diagnosis can vary greatly depending on the severity of the disorder of the central nervous system, on the frequency and timing of endoscopy, and on the interpretation of endoscopic findings.

 Gastric hemorrhagic lesions account for an overwhelming majority of Cushing ulcers, and these ulcers often develop in the body of the stomach.

 In accordance with past practice, hemorrhagic ulcers are treated by endoscopic hemostasis.

 Several studies have found that H2 receptor antagonists can prevent the onset of Cushing ulcers.

 In any case, it is important to consider the possibility of upper gastrointestinal lesions in patients with cerebrovascular disease.

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