Curling's ulcer is an acute
gastric erosion resulting as a complication from severe burns when reduced
plasma volume leads to
ischemia
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems ...
and cell
necrosis
Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. The term "necrosis" came about in the mid-19th century and is commonly attributed to German pathologist Rudolf Virchow, who i ...
(sloughing) of the
gastric mucosa
The gastric mucosa is the mucous membrane layer of the stomach, which contains the gastric pits, to which the gastric glands empty. In humans, it is about one mm thick, and its surface is smooth, soft, and velvety. It consists of simple secretor ...
. The condition was first described in 1823 and named after
Thomas Blizard Curling, who observed ten such cases in 1842.
These
stress ulcer
A stress ulcer is a single or multiple mucosal defect usually caused by physiological (not psychological) stress which can become complicated by upper gastrointestinal bleeding. These ulcers can be caused by shock, sepsis, trauma or other con ...
s (actually shallow multiple erosions) were once a common complication of serious burns, presenting in over 10% of cases,
and especially common in child burn victims. They result in perforation and
hemorrhage
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, ...
more often than other forms of intestinal ulceration and had correspondingly high mortality rates (at least 80%).
Treatment
While emergency surgery was once the only treatment, combination therapies including
enteral feeding
A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral fee ...
with powerful antacids such as
H2-receptor antagonists or, more recently,
proton pump inhibitors
Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of gastric acid, stomach acid production. They do so by irreversibly inhibiting the stomach's H+/K+ ATPase, H+/K+ ATPase proton pump. The body ...
such as
omeprazole
Omeprazole, sold under the brand names Prilosec and Losec, among others, is a medication used in the treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger–Ellison syndrome. It is also used to prevent up ...
have made Curling's ulcer a rare complication.
See also
*
Cushing ulcer
References
External links
{{Digestive system diseases
Duodenum disorders