An uncommon cause of gastro-duodenal ulceration

Abstract

causes of gastric or duodenal mucosal damage include excessive use of non-steroidal anti-inflammatory drugs, posttraumatic ischemic mucosal injury, hyperacidity caused by abuse of nicotine or changes in electrolytes, i.e. elevated serum calcium levels [1,2]

Gastroduodenal Ulceration Associated with Radioembolization for the Treatment of Hepatic Tumors: An Institutional Experience and Review of the Literature

“…In our experience, the time from radioembolization to ulcer diagnosis varied widely ranging from under 1 month to over 9 months (mean of 4 months). Other authors reported similar findings with diagnoses between 3 weeks and 7 months post 90 Y treatment [7,26,39,[41][42][43][44][45][46][47][48]. Taking into account our experience and the 21 cases from our literature review, the mean time to diagnosis is *3.2 months.…”

“…Unfortunately, this strategy failed to provide consistently favorable outcomes, with three of our five patients experiencing intractable symptoms and endoscopic evidence of persistent ulceration despite high-dose PPI therapy. Other authors have had similar success, with a response rate under 50% [7,26,39,[41][42][43][44][45][46][47][48].…”

“…Several patients experienced weight loss, dehydration, and malnutrition necessitating parenteral supplementation. Our literature review identified 11 publications providing detailed accounts of a total of 21 cases of radioembolizationinduced ulcers [7,26,39,[41][42][43][44][45][46][47][48]. Of these, 16 presented with abdominal pain and 12 with nausea/vomiting as part of their chief complaint.…”

“…Lesions in the pylorus and body were also commonly seen. Associated findings included gastritis, duodenitis, friability, granularity, and bleeding [7,26,39,[41][42][43][44][45][46][47][48].…”

Side Effects of Yttrium-90 Radioembolization

“…If GI ulceration is clinically suspected, endoscopy is recommended to confirm the diagnosis (39, 61). …”