Incidence of Malignancy and The Role of Gastric Biopsy in Patients with Perforated Gastric Ulcer in Maharaj Nakhon Si Thammarat Hospital
Keywords:
Gastric ulcer perforation, Gastric cancer, Gastric biopsyAbstract
Background: Perforated gastric ulcer is one of the most common diseases that require emergency surgery. The main etiology of perforation is benign ulcer but malignant ulcer is found in 5-16% of cases and difficult to be preoperatively diagnosed. Then routine gastric biopsy is recommended. But difference in behavior, characters, and etiology of gastric ulcer in Thai patient raise the question of the real incidence of gastric malignancy and the role of gastric biopsy in Thai patients.
Objectives : To determine the incidence of gastric malignancy and to explore the associated risk factors in the patients with perforated gastric ulcer, and to assess the role of gastric biopsy in the patient with gastric ulcer perforation at Maharaj Nakhon Si Thammarat Hospital, Thailand.
Materials and Methods: A retrospective study was conducted by reviewing medical records who were diagnosed of perforated gastric ulcer during January 1st, 2016 to December 30th, 2020 in Maharaj Nakhon Si Thammarat Hospital.
Results: The 210 records which had sufficient data were enrolled into the study. The incidence of malignancy in perforated gastric ulcer was 1.9% (4 of 210 patients). Two statistical significant factors that associated to malignancy were gross appearance of ulcer (OR 67.6, P<0.001) and the location of ulcer. The gross appearance of ulcer which associated to malignancy were chronic ulcer (25%, 1 of 4 patients) and mass like lesion (100%, 3 of 3 patients). None of 203 acute ulcers was malignancy. The ulcers that located at non-prepyloric area were significant asso-ciated to malignancy (OR 68.3, p<0.001).
Conclusion: The incidence of malignancy in perforated gastric ulcer was very low in this study. Two statistically significant factors that associated to malignancy were gross appearance and loca-tion of ulcer. Gastric biopsy maybe not necessary in acute ulcer that located atpre-pyloric area
Keywords: Gastric ulcer perforation,Gastric cancer, Gastric biopsy.
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นลิขสิทธิ์ของมหาราชนครศรีธรรมราชเวชสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากวารสารมหาราชนครศรีธรรมราชเวชสาร ก่อนเท่านั้น
