| 词条 | Cushing ulcer |
| 释义 |
| name = Cushing ulcer | image = | caption = | pronounce = | field = General surgery | synonyms = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} A Cushing ulcer, named after Harvey Cushing,[1][2] is a gastric ulcer associated with elevated intracranial pressure. It is also called von Rokitansky-Cushing syndrome. Apart from in the stomach, ulcers may also develop in the proximal duodenum and distal esophagus. CausesThe mechanism of development of Cushing ulcers is thought to be due to direct stimulation of vagal nuclei as a result of increased intracranial pressure. Alternatively, it may also be a direct result of Cushing reaction. Efferent fibers of the vagus nerve then release acetylcholine onto gastric parietal cell M3 receptors, causing insertion of hydrogen potassium ATPase vesicles into the apical plasma membrane. The end result is increased secretion of gastric acid with eventual ulceration of the gastric mucosa. DiagnosisAs Cushing ulcers have a higher incidence of developing after shock, sepsis or trauma, diagnosis should include recent medical history evaluation. Both endoscopy and angiography can be used to locate the lesion or ulcer, though endoscopy is more commonly used as a first-line diagnosis procedure.[3] TreatmentMost episodes of Cushing ulceration resolve on medical intervention, consisting primarily of rinsing the area with saline and the administration of antacids.[4] Patients should also be put on proton pump inhibitors during the course of treatment until their intracranial pressure lowers to a normal level{{cn|date=September 2018}}. See also
References1. ^{{WhoNamedIt|synd|982}} 2. ^{{Cite journal |last=Wijdicks |first=Eelco F.M. |date=2011-06-01 |title=Cushing's Ulcer: The Eponym and His Own |journal=Neurosurgery |language=en |volume=68 |issue=6 |pages=1695–1698 |doi=10.1227/neu.0b013e318212babf |pmid=21346647 |issn=0148-396X}} 3. ^{{Cite journal |last=Moody |first=F. G. |last2=Cheung |first2=L. Y. |date=Dec 1976 |title=Stress ulcers: their pathogenesis, diagnosis, and treatment |journal=The Surgical Clinics of North America |volume=56 |issue=6 |pages=1469–1478 |issn=0039-6109 |pmid=793064}} 4. ^{{Cite journal |last=Marrone |first=GC |last2=Silen |first2=W |date=May 1984 |title=Pathogenesis, diagnosis and treatment of acute gastric mucosal lesions. |url=https://europepmc.org/abstract/med/6430609 |journal=Clinics in Gastroenterology |language=en |volume=13 |issue=2 |issn=0300-5089}} External links{{Medical resources| DiseasesDB = 3259 | ICD10 = | ICD9 = | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = }}{{Digestive system diseases}}{{DEFAULTSORT:Cushing Ulcer}}{{disease-stub}} 1 : Duodenum disorders |
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