From Big Medical Encyclopedia

ULCER (ulcus) — defect of skin or mucous membrane and subjects of fabrics which processes of healing (development of granulyatsionny fabric, epithelization) are, as a rule, broken or are significantly slowed down.

The factors causing formation of ulcers are extremely various. Conditionally they can be divided on having the local damaging action (exogenous and endogenous) and the general (most often neyrotro-fichesky frustration). Quite often emergence of an ulcer is caused by the combined influence of those and other factors. An example of such ulcers are decubituses (see), in emergence to-rykh the main role play deep trophic disturbances in an organism. The direct damaging action of various factors and agents causes development of ulcers at thermal (see Burns, Freezing injuries) and beam damages (see), as a result of influence of various chemical substances — to - t, caustic alkalis other. Trophic ulcer processes (see. Trophic ulcers) quite often complicate the course of obliterating defeats of vessels of extremities (see), thrombophlebitis (see), especially at development of a posttromboflebitichesky syndrome, a varicosity (see), a diabetes mellitus (see a diabetes mellitus, Foot diabetic). Cankers of various localization are observed at infectious diseases, napr, at a typhoid (see), dysentery (see), syphilis (see), tuberculosis (see Tuberculosis extra pulmonary), a leushmaniosis (see), plague (see), a malignant anthrax (see), inflammatory purulent and allergic diseases.

Emergence of ulcer defects on a mucous membrane of a stomach and a duodenum is the basic morfol. by manifestation of a peptic ulcer (see), and also it is observed quite often at various, preferential chronic disturbances of blood circulation (so-called hypoxemic ulcers), long purpose of corticosteroids, uncontrolled use of nek-ry other pharmaceuticals (see. Side effects of pharmaceuticals, Ulcers symptomatic). After operative measures on a stomach sometimes there are round ulcers of a gastrointestinal anastomosis (see. Round ulcer). Blastomatous ulcers are formed as a result of disintegration of tumoral fabric and are found usually in primary tumor, is much more rare — in its metastasises in skin and mucous membranes.

Macroscopically ulcers can have various sizes, the form and depth. Assessment of these signs along with a careful research of edges and a bottom of an ulcer has essential value in recognition of origins of ulcer process. Acute ulcers usually superficial, have, as a rule, a rounded or oval shape with I do not ennoble - shchimisya the level of skin or mucous membrane edges. Microscopically acute ulcer is characterized by hl. obr. alterativny and exudative changes of the fabrics forming its bottom. The chronic ulcer can have most raznoobraz-. ny, sometimes irregular and bizzare shape; at the expressed cicatricial changes in area of edges and a bottom it quite often gets peculiar star-shaped outlines. In the subsequent on site such ulcer at its healing it is possible to find a star-shaped hem (see). Edges hron. ulcers are more often raised, dense, sometimes callused (a kal-lezny ulcer). Necrotic changes of fabrics in the field of a bottom of such ulcer are expressed at an aggravation of inflammatory process and proceed against the background of fibrosis and a sclerosis of surrounding fabrics. Healing hron. ulcers can be followed by formation of rough vicious hands, value to-rykh for an organism is defined by localization of defeat. E.g., leads scarring to serious consequences hron. ulcers of a peloric part of a stomach, coming to the end with development of a pyloric stenosis.

Heavy complications of ulcers went. - kish. a path the perforation (see) leading to the delimited or diffuse peritonitis (see) and a penetration in the next bodies are. Involvement in patol. process of vessels in the field of a bottom of an ulcer with their arrosion is the reason of bleeding (see). Pathological regeneration of a mucous membrane in the regions hron. ulcers, especially kallezny, can be a basis of a malignancy. To emphasize features of genesis of the malignant tumors developing at the same time, nek-ry researchers use the term «ulcer cancer».

Treatment of an ulcer is directed to hl. obr. on a basic disease.

M. N. Lantsman.