A 27-year-old male is admitted with severe burns covering 30% of his total body surface area. On day 4, he develops severe upper gastrointestinal bleeding with melena and hematemesis. Upper endoscopy demonstrates multiple acute, shallow gastric mucosal erosions. What is the specific clinical eponym for acute stress-related mucosal ulceration occurring in severe burn patients?

Answer and explanation

Correct answer: C. Curling ulcer

  1. Step 1: A Curling ulcer is an acute stress gastropathy ulcer resulting from severe extensive cutaneous burn trauma.
  2. Step 2: Hypovolemia and systemic ischemia cause mucosal hypoperfusion, acid hypersecretion, and disruption of the gastric mucosal barrier.
Answer
Curling ulcer.
Why not the others: 'Cushing ulcer' is an acute stress ulcer associated with elevated intracranial pressure or severe traumatic brain injury (mediated by vagal hyperstimulation and massive gastric acid hypersecretion); 'Dieulafoy lesion' is a large, tortuous submucosal arteriole that bleeds without ulceration; 'Cameron ulcer' occurs within a large hiatal hernia sac.

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