ĐẶC ĐIỂM LÂM SÀNG VÀ HÌNH ẢNH TỔN THƯƠNG QUA NỘI SOI Ở BỆNH NHÂN VIÊM LOÉT DẠ DÀY – TÁ TRÀNG CÓ HELICOBACTER PYLORI DƯƠNG TÍNH

Abstract

Background: Helicobacter pylori (H. pylori)-associated peptic ulcer disease (PUD) occurs across all age groups and has a high prevalence. However, its clinical presentation is often vague, with many cases being asymptomatic or presenting only with non-specific gastrointestinal symptoms. Objectives: To describe the clinical characteristics and endoscopic findings of H. pylori-positive peptic ulcer disease, and to investigate several factors associated with concomitant ulcerative lesions in these patients. Materials and methods: A cross-sectional descriptive study was conducted on 70 patients diagnosed with H. pylori-positive peptic ulcer disease at Can Tho Central General Hospital from June 2024 to February 2025. Results: The male/female ratio was approximately 1:1, with the majority of patients aged ≥50 years (61.4%). The prevalence of overweight and obesity was 28.6%. The proportions of patients who smoked, used corticosteroids, and used NSAIDs were 27.1%, 20.0%, and 37.1%, respectively. In terms of clinical symptoms, the most commonly reported were epigastric pain (82.9%), bloating (48.6%), epigastric burning (44.3%), acid regurgitation (42.9%), belching (40.0%), anorexia (38.6%), nausea (34.3%), altered stool characteristics (28.6%), vomiting (25.7%), and bowel habit changes (20.0%). Endoscopic findings predominantly revealed gastritis (n=68), most commonly antral gastritis (92.6%). Only two cases showed concurrent gastritis and duodenitis. Gastric ulcers were found in 16 patients, with 87.5% located in the antrum and 12.5% in the corpus. Duodenal ulcers were observed in three cases, 66.7% in the duodenal bulb (D1) and 33.3% in the second portion (D2). Only one case showed simultaneous gastric and duodenal ulcers. In terms of lesion characteristics, combined gastritis and ulcerative lesions accounted for 25.7%, while the remainder were cases of non-ulcerative gastritis. According to the Sydney classification, the majority of patients had erythematous gastritis (62.9%), followed by flat erosive gastritis (17.1%) and raised erosive gastritis (10.0%). Advanced age, smoking, corticosteroid use, and NSAID use were significantly associated with combined gastritis and ulcerative lesions (p<0.05). Conclusion: Most H. pylori-positive PUD patients were over 50 years old, with epigastric pain and various dyspeptic symptoms being the most prevalent. Endoscopy primarily revealed gastritis, particularly erythematous antral gastritis, while the prevalence of peptic ulcers remained relatively low. Elderly individuals, smokers, and those using corticosteroids or NSAIDs should be closely monitored due to their significant association with combined ulcerative lesions.