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Ulcers L17

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2023-bs-an-013
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6 views16 pages

Ulcers L17

Uploaded by

2023-bs-an-013
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Ulcers

Pathological Lesions
A lesion is “any abnormal change involving any tissue or
organ due to disease or injury.”
There are numerous types of lesions with different naming
classifications.
Lesions may be classified by their patterns, their sizes, their
locations, or their causes.
Ulcers
Ulcer is a pathological lesion
Ulcer is the breach of the continuity of skin, epithelium or
mucous membrane caused by sloughing out of inflamed
necrotic tissue.
It may either follow molecular death of the surface
epithelium or its traumatic removal.
Ulcers can occur due to:
◦ infection
◦ due to pressure on the skin e.g. pressure ulcers
◦ due to burning of mucous membrane by acid e.g. stomach
ulcers
◦ Lack of blood supply
◦ chemical burning and
◦ drug reactions are other causes.
Margin- Line of demarcation between normal and abnormal
Floor – The exposed part of an ulcer
Edge – Part between the margin and the floor of an ulcer
Base-the structure on which the ulcer rests (Felt on
palpation)
Stages of Ulcer
The life history of an ulcer consists of three phases.
Extension: During the stage of extension the floor is
covered with exudate and sloughs, while the base is
indurated. The discharge is exudative and can be blood
stained.
Transition: This stage prepares for healing. The floor
becomes cleaner, the sloughs separate, induration of the base
decreases and the discharge becomes more serous.
Small, reddish areas of granulation tissue appear on the floor
and these link up until the whole surface is covered.
Repair: The stage of repair consists of the transformation of
granulation to fibrous tissue, which gradually contracts to
form a scar. The epithelium gradually extends from the edge
to cover the floor.
Classification of ulcers
Etiological classification
Clinical classification
Pathological classification
Etiological classification of ulcers
On the basis of etiology ulcers are classified into:
◦ Traumatic ulcers ( due to trauma e.g. oral ulcers)
◦ Vascular ulcers (are wounds that are thought to occur due to
improper functioning of venous insufficiencies)
◦ Neoplastic ulcers
◦ Metabolic ulcers (Diabetic ulcers are the most common
manifestation of metabolic causes)
◦ Ulcers due to malnutrition
◦ Inflammatory ulcers
◦ Infective ulcers (peptic ulcers due to H. pylori )
◦ Miscellaneous ulcer
Clinical classification
According to clinical manifestation ulcers are classified into:
◦ Spreading ulcer (An ulcer with surrounding
inflammation)
◦ Healing ulcer (Slopping edge with red granulation tissue)
◦ Callous ulcer (Ulcer with no tendency to heal-with pale
granulation tissue)
Pathological Classification of Ulcer
Non-specific ulcers: these are due to infection of wounds,
or physical or chemical agents. Local irritation, as in the
case of a dental ulcer, or interference with the circulation
Specific ulcers: These include: Infective ulcers e.g.
Tuberculous ulcer, fungal ulcers etc.
Factors that can increase
the risk of ulcers
Use of NSAIDs (such as aspirin, naproxen, ibuprofen and many others
prescription medicines can cause ulcers
Excess acid production from gastrinomas (tumors of acid-producing
cells)
Excessive drinking
Smoking or chewing tobacco
Serious illness
Radiation treatment of the area
Who is more likely to
get ulcers
Those people are more like to get ulcers who:
◦ Are infected with H.pylori
◦ Overuse of NSAIDs (aspirin, ibuprofen or naproxen etc.)
◦ Have a family history of ulcers
◦ Have another illness such as liver, kidney or lung disease
◦ Drink regularly

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