UNASSIGNED: A man in his forties complained of epigastric discomfort. Esophagogastroduodenoscopy revealed a gastric ulcer in the lesser curvature of the gastric angle. After Helicobacter pylori was eradicated, the gastric ulcer recurred despite the administration of a potassium competitive acid blocker (PCAB), and a diagnosis of IPU was made. Twenty-four-hour intragastric pH monitoring revealed insufficient gastric acid suppression. Misoprostol was added to the patient\'s treatment. Subsequently, the ulcer healed and recurrence was not observed.
UNASSIGNED: For refractory IPU, the evaluation of pathophysiological function through 24-h gastric pH monitoring may lead to the selection of an appropriate treatment. If a proton pump inhibitor and PCAB do not improve the IPU, combination treatment with misoprostol may be considered as an option.
■一名四十多岁的男子主诉上腹部不适。食管胃十二指肠镜检查显示胃角较小曲率的胃溃疡。根除幽门螺杆菌后,胃溃疡复发,尽管施用钾竞争性酸阻滞剂(PCAB),并对IPU进行了诊断。24小时胃内pH监测显示胃酸抑制不足。在患者的治疗中加入米索前列醇。随后,溃疡愈合,未观察到复发。
■对于耐火IPU,通过24小时胃pH监测评估病理生理功能可能导致选择合适的治疗方法.如果质子泵抑制剂和PCAB不能改善IPU,可考虑与米索前列醇联合治疗.