Curling's ulcer

Curling's ulcer
Classification and external resources
DiseasesDB	3237
MeSH	D004381

Curling's ulcer (Stress Ulcer) or a Curling ulcer is an acute gastritis erosion resulting as a complication from severe burns when reduced plasma volume leads to ischemia and cell necrosis (sloughing) of the gastric mucosa. The condition was first described in 1823 and named for a doctor, Thomas Blizard Curling, who observed ten such patients in 1842.^[1]

These stress ulcers (actually shallow multiple erosions) were once a common complication of serious burns, presenting in over 10% of cases,^[1] and especially common in child burn victims.^[2] They result in perforation and hemorrhage more often than other forms of intestinal ulceration^[3] and had correspondingly high mortality rates (at least 80%).^[1] ^[4]

A similar condition involving elevated intracranial pressure is known as Cushing's ulcer.

Treatment

While emergency surgery was once the only treatment, combination therapies including enteral feeding with powerful antacids such as H₂-receptor antagonists or, more recently, proton pump inhibitors such as omeprazole have made Curling's ulcer a rare complication.^[5]

References

1 2 3 Pruitt, Basil A., Jr., F.D. Foley and John A. Moncrief (October 1970). "Curling's ulcer: a clinical-pathology study of 323 cases". Annals of Surgery 172 (4): 523–39. doi:10.1097/00000658-197010000-00001. PMC 1397279. PMID 5311720.
↑ Bruck, H.M. and Basil A. Pruitt, Jr. (June 1972). "Curling's ulcer in children: a 12-year review of 63 cases". Journal of Trauma 12 (6): 490–6. doi:10.1097/00005373-197206000-00006. PMID 5033495.
↑ Lev R; Klein, Martin S.; Ennis, Frank; Sherlock, Paul; Winawer, Sidney J. (December 1973). "Letter: Stress erosions". Am J Dig Dis 18 (12): 1099–100. doi:10.1007/BF01076530. PMID 4543410.
↑ Pedro-Pons, Agustín (1968). Patología y Clínica Médicas (in Spanish) 6 (3rd ed.). Barcelona: Salvat. p. 1198. ISBN 84-345-1106-1.
↑ Moran KT, O'Reilly T, Munster AM (October 1987). "A combined regimen for the prophylaxis of Curling's ulcer". Am Surg 53 (10): 575–6. PMID 2890321.

Diseases of the digestive system (primarily K20–K93, 530–579)

Upper GI tract

Esophagus	Esophagitis Candidal Eosinophilic Herpetiform Rupture Boerhaave syndrome Mallory-Weiss syndrome UES Zenker's diverticulum LES Barrett's esophagus Esophageal motility disorder Nutcracker esophagus Achalasia Diffuse esophageal spasm Gastroesophageal reflux disease (GERD) Laryngopharyngeal reflux (LPR) Esophageal stricture Megaesophagus

Stomach	Gastritis Atrophic Ménétrier's disease Gastroenteritis Peptic (gastric) ulcer Cushing ulcer Dieulafoy's lesion Dyspepsia Pyloric stenosis Achlorhydria Gastroparesis Gastroptosis Portal hypertensive gastropathy Gastric antral vascular ectasia Gastric dumping syndrome Gastric volvulus

Lower GI tract:
Intestinal/
Enteropathy

Small intestine (Duodenum/Jejunum/Ileum)	Enteritis Duodenitis Jejunitis Ileitis Peptic (duodenal) ulcer Curling's ulcer Malabsorption: Coeliac Tropical sprue Blind loop syndrome Small bowel bacterial overgrowth syndrome Whipple's Short bowel syndrome Steatorrhea Milroy disease bile acid malabsorption

Large intestine (Appendix/Colon)	Appendicitis Colitis Pseudomembranous Ulcerative Ischemic Microscopic Collagenous Lymphocytic Functional colonic disease IBS Intestinal pseudoobstruction / Ogilvie syndrome Megacolon / Toxic megacolon Diverticulitis/Diverticulosis

Large and/or small	Enterocolitis Necrotizing Gastroenterocolitis IBD Crohn's disease Vascular: Abdominal angina Mesenteric ischemia Angiodysplasia Bowel obstruction: Ileus Intussusception Volvulus Fecal impaction Constipation Diarrhea Infectious Intestinal adhesions

Rectum	Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus

Anal canal	Anal fissure/Anal fistula Anal abscess Anal dysplasia Pruritus ani

GI bleeding/BIS

Accessory

Liver	Hepatitis Viral hepatitis Autoimmune hepatitis Alcoholic hepatitis Cirrhosis PBC Fatty liver NASH Vascular Budd-Chiari syndrome Hepatic veno-occlusive disease Portal hypertension Nutmeg liver Alcoholic liver disease Liver failure Hepatic encephalopathy Acute liver failure Liver abscess Pyogenic Amoebic Hepatorenal syndrome Peliosis hepatis Metabolic disorders Wilson's Disease Hemochromatosis

Gallbladder	Cholecystitis Gallstones/Cholecystolithiasis Cholesterolosis Rokitansky-Aschoff sinuses Postcholecystectomy syndrome Porcelain gallbladder

Bile duct/ Other biliary tree	Cholangitis Primary sclerosing cholangitis Secondary sclerosing cholangitis Ascending Cholestasis/Mirizzi's syndrome Biliary fistula Haemobilia Gallstones/Cholelithiasis Common bile duct Choledocholithiasis Biliary dyskinesia Sphincter of Oddi dysfunction

Pancreatic	Pancreatitis Acute Chronic Hereditary Pancreatic abscess Pancreatic pseudocyst Exocrine pancreatic insufficiency Pancreatic fistula

Abdominopelvic

Hernia	Diaphragmatic Congenital Hiatus Inguinal Indirect Direct Umbilical Femoral Obturator Spigelian Lumbar Petit's Grynfeltt-Lesshaft Undefined location Incisional Internal hernia

Peritoneal	Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum

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