Erosive and ulcerative gastroduodenopathy in patients with lower extremity vascular disease

A.I. Dolgushina¹, A.A. Selyanina¹, A.S. Kuznetsova¹, A.A. Baryshnikov², M.R. Alipakhanov², A.R. Molchanova¹

¹South Ural State Medical University, Chelyabinsk

²Chelyabinsk Regional Clinical Hospital

Patients with lower extremity vascular disease (LEVD) have risk factors of erosive and ulcerative gastroduodenopathy. Currently, there are few studies on the incidence and structure of digestive diseases in patients with LEVD.

Aim: to assess the incidence and clinical and endoscopic characteristics of erosive and ulcerative gastroduodenopathy in patients with different severity of LEVD.

Patients and Methods: the study involved 60 patients with IIA-IV stage LEVD according to Fontaine (I-III grade according to Rutherford): group I — 26 patients without chronic lower limb ischemia (CLLI), group II — 34 patients with CLLI, among them 41 (68.3%) men and 19 (31.7%) women. The median age of patients was 67.0 (61.0–74.8) years. All patients underwent multislice computed tomoangiography (MSCT-AG) of visceral branches in the abdominal aorta and lower limb arteries, esophagogastroduodenoscopy (EGDS), punch biopsy of the antral mucosa and the stomach body with the subsequent morphological examination.

Results: diseases of the upper gastrointestinal tract (GIT) were detected in 53 (88.3%) patients with LEVD, among them erosive and ulcerative lesions of the upper GIT — in 34 (64.2%). Statistically significant differences in the upper GIT diseases incidence were revealed between patients of groups I and II: in patients without CLLI, this parameter was 20 (77.0%), in the presence of CLLI — 33 (97%), p=0.017. Erosions, gastric ulcers and duodenal bulb ulcers were significantly more common in 75.8% of patients with CLLI, and in 45% of patients without CLLI (p=0.024).

Conclusion: in patients with LEVD, erosive and ulcerative lesions in the gastroduodenal area were revealed in 64.2%, which were more common in patients with CLLI. At the same time, disease clinical manifestations in the upper GIT occurred only in 48.3% of patients.

Keywords: peripheral arterial disease, chronic lower limb ischemia, gastroduodenopathy, erosive and ulcerative gastroduodenopathy, lower extremity vascular disease, chronic atrophic gastritis, chronic nonatrophic gastritis, mesenteric ischemia.

For citation: Dolgushina A.I., Selyanina A.A., Kuznetsova A.S. et al. Erosive and ulcerative gastroduodenopathy in patients with lower extremity vascular disease. RMJ. 2019;12:69–72.