{{Infobox medical condition (new) | name = Cushing ulcer | image = | caption = | pronounce = | field = General surgery | synonyms = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} A '''Cushing ulcer''', named after Harvey Cushing,<ref>{{WhoNamedIt|synd|982}}</ref><ref name=wijdicks2010>{{Cite journal |last=Wijdicks |first=Eelco F.M. |date=2011-06-01 |title=Cushing's Ulcer: The Eponym and His Own |journal=Neurosurgery |language=en |volume=68 |issue=6 |pages=1695–1698 |doi=10.1227/neu.0b013e318212babf |pmid=21346647 |issn=0148-396X}}</ref> is a gastric ulcer associated with elevated intracranial pressure. It is also called von Rokitansky–Cushing syndrome.<ref name=wijdicks2010/> Apart from the stomach, ulcers may also develop in the proximal duodenum and distal esophagus.

==Causes== The mechanism of development of Cushing ulcers is thought to be due to direct stimulation of vagal nuclei as a result of increased intracranial pressure. Brain tumors, traumatic head injury, and other intracranial processes including infections, can cause increased intracranial pressure and lead to overstimulation of the vagus nerve.<ref name="pmid25972936">{{cite journal | vauthors = Kemp WJ, Bashir A, Dababneh H, Cohen-Gadol AA | title = Cushing's ulcer: Further reflections | journal = Asian J Neurosurg | volume = 10 | issue = 2 | pages = 87–94 | date = 2015 | pmid = 25972936 | pmc = 4421974 | doi = 10.4103/1793-5482.154976 | doi-access = free }}</ref> Efferent fibers of the vagus nerve then release acetylcholine onto gastric parietal cell M<sub>3</sub> receptors, causing insertion of hydrogen potassium ATPase vesicles into the apical plasma membrane. The end result is increased secretion of gastric acid with eventual ulceration of the gastric mucosa.

==Diagnosis== As Cushing ulcers have a higher incidence of developing after shock, sepsis or trauma, diagnosis should include recent medical history evaluation. Both endoscopy and angiography can be used to locate the lesion or ulcer, though endoscopy is more commonly used as a first-line diagnosis procedure.<ref>{{Cite journal |last1=Moody |first1=F. G. |last2=Cheung |first2=L. Y. |date=Dec 1976 |title=Stress ulcers: their pathogenesis, diagnosis, and treatment |journal=The Surgical Clinics of North America |volume=56 |issue=6 |pages=1469–1478 |issn=0039-6109 |pmid=793064|doi=10.1016/s0039-6109(16)41099-6 }}</ref>

==Treatment== Most episodes of Cushing ulceration resolve on medical intervention, consisting primarily of rinsing the area with saline and the administration of antacids.<ref>{{Cite journal |last1=Marrone |first1=GC |last2=Silen |first2=W |date=May 1984 |title=Pathogenesis, diagnosis and treatment of acute gastric mucosal lesions. |journal=Clinics in Gastroenterology |language=en |volume=13 |issue=2 |pages=635–50 |issn=0300-5089|pmid=6430609 }}</ref>

==See also== * Curling ulcer

==References== {{reflist}}

==External links== {{Medical resources | DiseasesDB = 3259 | ICD10 = | ICD9 = | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = }} {{Digestive system diseases}}

{{DEFAULTSORT:Cushing Ulcer}} Category:Duodenum disorders