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Gideon Goldman, MD; Elsa Tiomny, MD; Perry J. Kahn, MD; Dalia Somjen, PhD; Zamir Halpern, MD; Tuvia Gilat, MD; Theodor Wiznitzer, MD

Arch Surg. 1989;124(6):724-726.

Abstract
• Prostaglandins are presumed to have many cytoprotective properties that play a role in the pathogenesis of duodenal ulcer and its complications where decreased levels of prostaglandin E₂ (PGE₂) impair gastric motility, oppose ionic membrane influx, and enhance obstructive changes. These are just some of the mechanisms that may cause pyloric obstruction and may result from decreased PGE₂ levels. To evaluate this hypothesis, 17 patients with duodenal ulcer complicated by pyloric stenosis were examined. Biopsy specimens were obtained from the duodenal bulb, ulcer margins, gastric antrum, fundus, and gastric secretions. Prostaglandin E₂ levels were measured and compared with those taken from the same areas during a second endoscopy in a later quiescent or exacerbated phase. During the active phase of pyloric stenosis, decreased levels of PGE₂ were found in the gastroduodenal tissues and secretions were compared with levels found during convalescence. These level differences were statistically significant. A correlation between the severity of the clinical and endoscopic findings and the PGE₂ levels was found. A further decrease in PGE₂ levels in the second endoscopy were indicative of the presence of scar tissue, representing an irreversible obstructive peptic disease.

(Arch Surg 1989;124:724-726)

Author Affiliations
From the Departments of Surgery "A" (Drs Goldman, Tiomny, Kahn, and Wiznitzer) and Gastroenterology (Drs Halpern and Gilat) and the Tissue Laboratory (Dr Somjen), Ichilov Hospital, Tel-Aviv Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Footnotes
Accepted for publication Aug 29, 1988.

Reprints not available.

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