Introducere. Atentia noastra a fost atrasa de unele acuze ale bolnavilor cu sifilis secundar, legate de sistemul gastro-duodenal, aparute in timpul infectiei sifilitice. Exista o serie de publicatii, care semnaleaza cazuri unice de afectari gastrice si intestinale in siflis, bazate pe semnele subiective (dureri epigastrice, voma, greturi, inapetenta etc.). O serie de bolnavi initial s-au adresat la internisti, gastrologi, chirurgi, oncologi cu acuzele mentionate mai sus, care predominau in tabloul clinic. Testati serologic, ei au fost indreptati pentru tratament in sectiile specializate, urmand sa se reintoarca la tratamentul afectiunilor gastro-duodenale.
Scopul lucrarii a fost studiul afectiunilor mucoasei gastrice si duodenale la bolnavii cu sifilis secundar.
Material. Au fost examinati 30 bonavi cu sifilis secundar, in acuzele carora predominau semnele gastro-duodenale (greturi, dureri epigastrice, voma, inapetenta etc.). Barbati au fost 24, femei - 6. In varsta de 20-30 ani au fost 16, 31-40 ani - 8, 41-46 ani - 6. Pentru toti pacientii au fost comune eruptiile specifice diseminate, afectarea tegumentelor si mucoaselor (angina eritemato-papuloasa, eruptii eritemato-papuloase pe trunchi si organele genitale, sifilide palmo-plantare etc.). Din cauza acuzelor digestive toti pacientii au fost spitalizati sau examinati initial in diverse sectii somatice: gastrologie - 19, gastrochirurgie - 9, oncologie - 2.
Metode. La cei 30 pacienti a fost efectuat examenul fibrogastroduodenoscopic si histopatomorfologic.
Rezultate. Gastrita eroziv-ulceroasa a fost stabilita la 20 pacienti. Bulbita eroziva, duodenita eroziva superficiala - la 8 pacienti. Esofagita catarala - la 3 bolnavi. La 2 pacienti s-au depistat ulcere gigante ale corpului gastric. La toti pacientii s-a stabilit reflux duodeno-gastric si o cantitate mare de bila in stomac. Histopatomorfologic la majoritatea pacientilor s-a inregistrat hiperplazie pronuntata a epiteliului prismatic pe fondul infiltratului limfoplasmocitar pronuntat.
Concluzii: 1. Gastroduodenita eroziv-ulceroasa specifica in sifilisul secundar a fost stabilita la persoane de varsta tanara, mai frecvent intalnindu-se la barbati.2. Evolutia sifilisului la aceste persoane este agresiva, cu eruptii specifice diseminale.3. Refluxul duodeno-gastric si cantitatea mare de bila in stomac favorizeaza aparitia eruptiilor specifice la nivelul mucoasei gastro-duodenale.4. Dereglarile subiective dispar pe parcursul tratamentului antisifilitic timp de 7-10 zile, cele tisulare - timp de 3-6 saptamani.5. Afectiunile gastro-duodenale in cadrul sifilisului secundar, in marea lor majoritate, nu necesita un tratament suplimentar.

Introduction. Our attention has been drawn by some complaints of patients with secondary syphilis. Complaints were linked to the gastrointestinal system that appeared during syphilitic infection. There is a series of publications that mention cases of gastrointestinal implication in syphilis, based on subjective signs (epigastric pain, vomiting, nausea, loss of appetite etc.). Some patients addressed to internists, gastrologists, surgeons and oncologists with the aforementioned signs that were predominant in clinical presentation. Being tested serologically, they were then referred for treatment in specialized departments and had to resume treatment for their gastrointestinal condition.
Goal of this study is to research gastric and duodenal manifestations in patients with secondary syphilis.
Material. There were examined 30 patients with secondary syphilis, in whose complains were predominant gastrointestinal signs (nausea, epigastric pains, vomiting, loss of appetite etc.). There were 24 men and 6 women of those 16 were 20-30 y.o., 8 were 31-40 y.o. and6 were 41-46 y.o. All patients had specific disseminated cutaneous and mucosal lesions, (erythemato-papulous tonsillitis, erythemato-papulous lesions on torso and genitals, palmar and plantar syphilitic lesions). All patients were hospitalized or examined initially in somatic departments: gastrology - 19, gastrosurgery - 9, oncology - 2.
Methods. All 30 patients have under gone fiberscopic gastroduodenal investigation with subsequent morphologic testing.
Results. Erosive gastritis was found in 20 patients. Erosive bulbits and superficial erosive duodenitis were found in 8 patients. Three patients had catharal esofagitis. Two patients had gigantic ulcers of the stomach. All patients had duodenogastric reflux and a big quantity of bile in the stomach. Most patients had marked hiperplasia of prismatic epithelium on the background of marked lymphoplasmacytic infiltrate.
Conclusions:1. Erosive gastroduodenitis specific for secundary syphilis was found in young patients, more frequently in males.2. Evolution of syphilis in these patients is aggressive, with specific disseminated lesions.3. The duodenogastric reflux and the big quantity of bile in the stomach facilitate the development of specific lesions of gastrointestinal system.Subjective manifestations disappear as treatment od syphilis is initiated in 7-10 days, and the tissue manifestations - in 3-6 weeks.5. The gastroduodenal manifestations in secondary syphilis, in their majority, do not require additional treatment.