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a local defect, or excavation of the surface of an organ or tissue, produced by sloughing of necrotic inflammatory tissue.
aphthous ulcer a small painful ulcer in the mouth, approximately 2 to 5 mm in diameter. It usually remains for five to seven days and heals within two weeks with no scarring.
chronic leg ulcer ulceration of the lower leg caused by peripheral vascular disease involving either arteries and arterioles or veins and venules of the affected limb. Arterial and venous ulcers are quite different and require different modes of treatment. Venous stasis ulcers occur as a result of venous insufficiency in the lower limb. The insufficiency is due to deep vein thrombosis and failure of the one-way valves that act during muscle contraction to prevent the backflow of blood. Chronic varicosities of the veins can also cause venous stasis.
Patient Care. Stasis ulcers are difficult to treat because impaired blood flow interferes with the normal healing process and prolongs repair. Patient care is concerned with preventing a superimposed infection in the ulcer, increasing blood flow in the deeper veins, and decreasing pressure within the superficial veins.
decubitus ulcer pressure ulcer.
duodenal ulcer an ulcer of the duodenum, one of the two most common types of peptic ulcer.
gastric ulcer an ulcer of the inner wall of the stomach, one of the two most common kinds of peptic ulcer.
Hunner's ulcer one involving all layers of the bladder wall, seen in interstitial cystitis.
hypertensive ischemic ulcer a manifestation of infarction of the skin due to arteriolar occlusion as part of a longstanding vascular disease, seen especially in women in late middle age, and presenting as a red painful plaque on the lower limb or ankle that later breaks down into a superficial ulcer surrounded by a zone of purpuric erythema.
marginal ulcer a peptic ulcer occurring at the margin of a surgical anastomosis of the stomach and small intestine or duodenum. Marginal ulcers are a frequent complication of surgical treatment for peptic ulcer; they are difficult to control medically and often require further surgery.
peptic ulcer see peptic ulcer.
perforating ulcer one that involves the entire thickness of an organ, creating an opening on both surfaces.
1. any of a group of conditions due to secondary bacterial invasion of a preexisting cutaneous lesion or the intact skin of an individual with impaired resistance as a result of a systemic disease, which is characterized by necrotic ulceration associated with prominent tissue destruction.
pressure ulcer see pressure ulcer.
rodent ulcer ulcerating basal cell carcinoma of the skin.
stress ulcer a type of peptic ulcer, usually gastric, resulting from stress; possible predisposing factors include changes in the microcirculation of the gastric mucosa, increased permeability of the gastric mucosa barrier to H+, and impaired cell proliferation.
trophic ulcer one due to imperfect nutrition of the part.
tropical phagedenic ulcer a chronic, painful phagedenic ulcer usually seen on the lower limbs of malnourished children in the tropics; the etiology is unknown, but spirochetes, fusiform bacilli, and other bacteria are often present in the developing lesion, and protein and vitamin deficiency with lowered resistance to infection may play a role in the etiology.
varicose ulcer an ulcer due to varicose veins.
venereal ulcer a nonspecific term referring to the formation of ulcers resembling chancre or chancroid about the external genitalia; there are both sexually transmitted and other types.
an ulcer of the duodenum in a patient with extensive superficial burns, intracranial lesions, or severe bodily injury.
Synonym(s): Curling ulcer
Risk factors, non-critical medical patients Respiratory failure, sepsis, heart failure, hepatic encephalopathy, jaundice, renal failure, stroke, hypertension, previous GI disease and treatment with corticosteroids, NSAIDS, heparin, or warfarin
Risk factors, surgical patients Mechanical ventilation, coagulopathy
Management Stress ulcer prevention—antacids, H2-receptor blockers, sucralfate, proton pump inhibitors, prostaglandin analogs, and nutrition—is easier than managing stress ulcers.
stress ulcerStress ulceration GI disease An erosion of the gastric mucosa, attributed to physical or mental stress Risk factors Respiratory failure, coagulopathy Management Ranitidine. See Executive monkey, Ranitidine, 'Toxic core, ' Type A personality. Cf Sucralfate.
Stress ulcer types*
Activity ulcer A type of gastric erosion produced when rats are placed in a running wheel with access to food for only 1 hr/day
Exertion ulcer Gastric ulceration that is associated with excessive and unexpected forced activity, eg a rotating cage keeps the rodents constantly running and the gastric juices flowing to the maximum
Restraint ulcer An ulcer that appears in rats hours after placement in a very confined spaces, especially when the ambient temperature is lowered
Shock ulcer Gastric ulcer in humans related to burns, eg Curling's ulcer, ischemia, neurologic injury, eg Cushing's ulcer, sepsis or trauma
*Given the association of gastric ulcers with H pylori; many respond to antibiotics; because bleeding from SUs is relatively rare, but has a high mortality–in one report, 49% vs 9% without hemorrhage, the use of prophylactic measures, eg neutralization of gastric acid, ↓ gastric acid secretion and cytoprotection is commonly recommended; prophylaxis is best administered to those at highest risk–respiratory failure-odds ratio 15.6, coagulopathy-odds ratio 4.3) for GI bleeding and can be withheld from other Pts–NEJM 1994; 330:377oa
stress ul·cer(stres ŭl'sĕr)
A lesion of the duodenum in a patient with extensive superficial burns, intracranial lesions, or severe bodily injury.
Synonym(s): Curling ulcer.
Synonym(s): Curling ulcer.