Curling's ulcer

Curling's ulcer or a Curling ulcer is an acute peptic ulcer of the duodenum 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 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