title: ["Stress" ulcer - acute ulcerous and erosive lesions in the gastroduodenal mucosa].
abstract: Acute gastroduodenal mucosal lesions are observed following shock, sepsis, trauma, bat also after the ingestion of certain substances (alcohol) and in the course of severe, chronic medical illness. The so-called cushing ulcus should probably be separated from the clinical syndrome of stress ulcer. We must also exclude without any discussion reactivated chronic duodenal or ventricular ulcers with their complications, often manifested after serious trauma or illness. Digestive complaints are absent from the history of illness. The earliest manifest sign is in most cases severe gastrointestinal haemorrhage. It appears that the presence of Hydrogen ions in gastric contents and mucosal ischaemia are required for stress ulcer to develop, in which process damage to the "mucosal barrier" is also instrumental. The basic diagnostics is endoscopy. Angiography is only indicated in patients where endoscopy has failed. Conservative therapy brings haemorrhage under control in most cases. Surgery is indicated only if conservative therapy has proved inadequate to control bleeding or in cases of free perforation. Optimal surgical treatment remains a matter of discussion since no surgical method, except total gastrectomy, can protect the patient from recurrent haemorrhage.
mesh_terms: D006801:Humans; D010437:Peptic Ulcer / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D013315:Stress, Psychological / Q000150:complications*; D014947:Wounds and Injuries / Q000150:complications
vernacular_title: "Stress" ulkus -  akutne ulkusne i erozivne lizije sluznice zeluca i dvanaesnika.