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Duodenal Ulcer with Obstruction


Presentation

  • Cite this Apa Standard Harvard Vancouver BIBTEX RIS @article{771669ec3fbf4593bcd214047523073c, title "Disseminated histoplasmosis presenting with biliary obstruction and duodenal ulcer.[uthsc.pure.elsevier.com]
  • The oft-cited chapter on the principles of evidence-based decision-making in surgical practice is completely updated for the second edition, presenting the reader with a framework for the evidence-based practice of surgery.[books.google.com]
  • Gastrointestinal tuberculosis presenting as isolated involvement of the duodenum is a rare case. Case Presentation: A 13 year male, presented with features of gastric outlet obstruction.[casereports.bmj.com]
  • Right: Post-bulbar duodenal stricture in a 61 year-old woman with a history of peptic ulcer disease, who had presented with symptoms suggestive of partial gastric outlet obstruction.[endoatlas.com]
Weight Loss
  • Maldigestion and steatorrhea caused by pancreaticobiliary bypass, especially with Billroth II anastomosis, may contribute to weight loss.[merckmanuals.com]
  • The post-gastrectomy syndromes include: Small capacity or 'small stomach' syndrome - this is associated with fullness after only moderate-sized meals and may be associated with weight loss and reduced appetite.[patient.info]
  • Symptoms can include: repeated episodes of vomiting, with large amounts of vomit that contain undigested food a persistent feeling of bloating or fullness feeling very full after eating less food than usual unexplained weight loss An endoscopy can be[nhs.uk]
  • loss Pain increases 2–5 hours after eating Pain on an empty stomach (hunger pain ) that is relieved with food intake weight gain Nocturnal pain 30–40% of patients 50–80% of patients Taking NSAIDs can often mask PUD symptoms until complications such as[amboss.com]
  • Other symptoms may include: Bloated feeling Burping Lack of appetite or weight loss Nausea Bloody or dark poop Vomiting Small ulcers may not cause any symptoms. But if you notice any of these signs, talk to your doctor.[webmd.com]
Splenectomy
  • Primary Sclerosing Cholangitis 1093 Biliary Malignant 1103 Perihilar Cholangiocarcinoma 1105 Cancer of the Gallbladder 1111 Spleen Benign 1121 Splenectomy 1123 Cyst and Abscess of the Spleen 1135 Spleen Malignant 1143 Malignant Diseases of the Spleen[books.google.com]
Goiter
  • Application of Sentinel Lymph Node Biopsy in Melanoma 1591 Surgical Treatment of Malignant Melanoma 1597 Surgical and Medical Management of Locally Advanced and Systemic Melanoma 1605 Soft Tissue Sarcomas of the Extremities and Chest Wall 1617 Endocrine 1629 Goiter[books.google.com]
Hemoptysis
  • 1315 Laparoscopic Appendectomy 1323 Laparoscopic Small Bowel Surgery 1331 Laparoscopic Common Bile Duct Exploration 1343 Advanced Gastric and Pancreatic Laparoscopic Procedures 1351 Thoracic 1363 Infections of the Pleural Cavity 1365 Lung Abscess 1375 Hemoptysis[books.google.com]
Vomiting
  • Nausea and Vomiting Obstruction of the duodenum can also cause patients to become nauseated and vomit.[livestrong.com]
  • Symptoms can include: repeated episodes of vomiting, with large amounts of vomit that contain undigested food a persistent feeling of bloating or fullness feeling very full after eating less food than usual unexplained weight loss An endoscopy can be[nhs.uk]
  • Weakness, dizziness, sweating, nausea, vomiting, and palpitations occur soon after eating, especially hyperosmolar foods.[merckmanuals.com]
  • An infant will vomit feedings, lose weight, and be restless and irritable.[encyclopedia.com]
Nausea
  • Nausea and Vomiting Obstruction of the duodenum can also cause patients to become nauseated and vomit.[livestrong.com]
  • […] vomiting heartburn moody pms or vomiting heartburn moody pms or two and have had the following symptoms: nausea vomiting heartburn Make These 8 Simple Changes for a Healthy Fall Taking any of these may sound utterly strange at first but I was getting[transnationalterrorism.eu]
  • Side effects of medications used to treat stomach ulcers can include: nausea dizziness headaches diarrhea abdominal pain These side effects are typically temporary.[healthline.com]
  • […] than gastric ulcers. typically in age 25-30 what is duodenal ulcer associated with smoking alcholo NSAIDs H.pylori (85%) clinical feature cyclical pain develops 1-3h after meal hunger pain and central back pain pain is relieved by eating or anatacids nausea[quizlet.com]
  • Less common ulcer symptoms may include: Feeling full after eating a small amount of food Burping Nausea Vomiting Not feeling hungry Losing weight without trying Bloody or black stool Vomiting blood Peptic ulcer symptoms may look like other health problems[hopkinsmedicine.org]
Abdominal Pain
  • Abdominal pain, diarrhea, GI bleeding, hepatosplenomegaly and small bowel obstruction are well described presentations. Still gastrointestinal histoplasmosis often results in either vague symptomatology or no symptoms.[uthsc.pure.elsevier.com]
  • Symptoms include Severe abdominal pain or cramping Vomiting Bloating Loud bowel sounds Swelling of the abdomen Inability to pass gas Constipation A complete intestinal obstruction is a medical emergency. It often requires surgery.[icdlist.com]
  • The pattern of abdominal pain may depend on the location of the ulcer.[verywell.com]
  • pain worse with eating.[medbullets.com]
  • The most common symptom of peritonitis is sudden abdominal pain that gets steadily worse. If you have this type of pain, contact your GP immediately. If this isn't possible, call NHS 111 or your local out-of-hours service .[nhs.uk]
Epigastric Pain
  • pain, radiating to the back.pain is unreleated to mealds.[quizlet.com]
  • Epigastric pain is a typical symptom of PUD, however, some patients may remain asymptomatic. Diagnosis occurs via direct visualization of the ulcer on esophagogastroduodenoscopy ( EGD ) and H. pylori detection (via biopsy or non-invasive testing).[amboss.com]
  • There is sudden, intense, continuous epigastric pain that spreads rapidly throughout the abdomen, often becoming prominent in the right lower quadrant and at times referred to one or both shoulders.[merckmanuals.com]
  • Symptoms of complicated peptic ulcer disease Although epigastric pain is the cardinal symptom of ulcer, other symptoms may occur when PUD becomes complicated.[clinicaladvisor.com]
  • Clinical features As in duodenal ulceration the usual presentation is epigastric pain. The pain is typically exacerbated by food; nausea, unremitting pain and weight loss are common.[surgwiki.com]
Recurrent Vomiting
  • Individuals with gastric outlet obstruction will often have recurrent vomiting of food that has accumulated in the stomach, but which cannot pass into the small intestine due to the obstruction.[en.wikipedia.org]
  • vomiting, or a family history of GI cancer.[clinicaladvisor.com]
  • “Alarm features" that warrant prompt gastroenterology referral [1] include bleeding, anemia, early satiety, unexplained weight loss, progressive dysphagia or odynophagia, recurrent vomiting, and family history of gastrointestinal (GI) cancer.[emedicine.medscape.com]
Hepatosplenomegaly
  • Abdominal pain, diarrhea, GI bleeding, hepatosplenomegaly and small bowel obstruction are well described presentations. Still gastrointestinal histoplasmosis often results in either vague symptomatology or no symptoms.[uthsc.pure.elsevier.com]
Ectopia Lentis
  • الصفحة 896 - Genetic linkage of the Marfan syndrome, ectopia lentis, and congenital contractural arachnodactyly to the fibrillin genes on chromosomes 15 and 5. N Engl J Med 1992;326:905-909. ‏[books.google.com]
Skin Lesion
  • Breast Ductal and Lobular Origin 1509 Breast Carcinoma Stages I and II 1523 Locally Advanced Breast Cancer 1541 Metastatic Carcinomas of the Breast 1551 Reconstruction of the Breast 1563 Skin Soft Tissues 1569 Evaluation of Malignant and Premalignant Skin[books.google.com]

Workup

  • You might have to undergo a more extensive medical workup looking for unusual underlying causes for peptic ulcer disease.[verywell.com]
  • (See Workup .) Upper GI endoscopy is the preferred diagnostic test in the evaluation of patients with suspected peptic ulcer disease.[emedicine.medscape.com]

Treatment

  • 1219 Nonfunctioning Pancreatic Endocrine Tumors 1233 Hernia 1245 Femoral Hernia 1247 Inguinal Hernia 1257 Incisional Hernia Repair 1267 Uncommon Abdominal Wall Hernias 1275 Gastrointestinal Bleeding 1283 Upper Gastrointestinal Hemorrhage Diagnosis and Treatment[books.google.com]
  • Results of medical treatment of peptic ulcer. J.A.M.A. 95 :1144, 1930. Google Scholar 4. Lahey, F. H. Treatment of gastric and duodenal ulcer. J.A.M.A. 95 :313, 1930. Google Scholar 5. Grifone, J. W. , and Brown, C. H.[link.springer.com]
  • * The best news is that this treatment has a money back guarantee and it works without the negative effects* associated with chemical based treatments![ulcer-cure.com]
  • Together you can discuss your symptoms and treatment options.[healthline.com]

Prognosis

  • Prognosis A functioning and unrestricted intestine is a prerequisite for living independent of the most advanced and continuous medical care available. Achieving this desirable goal is the rule with surgery for duodenal obstructions of all types.[medical-dictionary.thefreedictionary.com]
  • Prognosis Prognosis will depend on the type and extent of the obstruction, the infant's age at diagnosis, the infant's overall condition, and the presence and severity of any other congenital anomalies.[encyclopedia.com]
  • In the rare cases when surgery cannot be done, prognosis is poor. Obstruction may be caused by scarring, spasm, or inflammation from an ulcer.[merckmanuals.com]
  • A Word From Verywell While a peptic ulcer is a significant medical problem that can have dire consequences, advances in medical care over the past few decades have utterly changed the treatment of this condition and the prognosis of the people who have[verywell.com]
  • When the underlying cause of peptic ulcer disease is addressed, the prognosis is excellent.[emedicine.medscape.com]

Etiology

  • Etiology Risk factors Chronic gastritis caused by H. pylori, a curved, flagellated gram-negative rod Duodenal ulcers : up to 90% are due to H. pylori infection Gastric ulcers : up to 80% are due to H. pylori infection Chronic gastritis of other etiology[amboss.com]
  • Pathology Etiology Gastric outlet obstruction can be due to malignant or benign causes.[radiopaedia.org]
  • Complications can occur in patients with peptic ulcer of any etiology.[karger.com]
  • There is no increased risk of cancer with ulcers of other etiology.[merckmanuals.com]
  • The etiology of Brunner’s gland hyperplasia is not known. It is hypothesized that excess gastric acid secretion or increased inflammation may lead to hyperplasia[2].[ghrnet.org]

Epidemiology

  • Management of Chronic Peripheral Arterial Occlusive Disease 1811 Visceral Artery Occlusive Disease Mesenteric Occlusive Disease 1827 Acute Arterial Occlusions 1837 Venous and Lymphatic Disease 1847 Vascular Access for Hemodialysis 1861 The Diabetic Foot Epidemiology[books.google.com]
  • Epidemiology References: [1] [2] [3] [4] [5] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • […] cyclophosphamide Local radiation resulting in mucosal damage, which may lead to the development of duodenal ulcers Use of crack cocaine, which causes localized vasoconstriction, resulting in reduced blood flow and possibly leading to mucosal damage Epidemiology[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Malignant Tumours of the stomach, including adenocarcinoma (and its linitis plastica variant), lymphoma, and gastrointestinal stromal tumours Pathophysiology [ edit ] In a peptic ulcer it is believed to be a result of edema and scarring of the ulcer,[en.wikipedia.org]
  • Pathophysiology Intrinsic or extrinsic obstruction of the pyloric channel or duodenum is the usual pathophysiology of GOO; as previously noted, the mechanism of obstruction depends upon the underlying etiology.[laparoscopyhospital.com]
  • (A comprehensive review of Zollinger-Ellison Syndrome, outlining the pathophysiology, diagnosis, and therapy of this disorder.) Gibril, F, Reynolds, JC, Doppman, JL.[clinicaladvisor.com]
  • References: [12] Pathophysiology Clinical features Gastric ulcer Duodenal ulcer Findings common to both Dyspepsia : postprandial heaviness, early satiety, and gnawing, aching or burning epigastric pain Pain relief with antacids Potential signs of internal[amboss.com]
  • Pediatric Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, 3rd ed. Boston, MA: B. C. Decker, 2000. "Intestinal Obstruction." The Merck Manual of Medical Information, 2nd ed. Edited by Mark H. Beers et al.[encyclopedia.com]

Prevention

  • Oversew the area with a continuous suture to prevent a postoperative leak. No drainage procedure is required. E. Complications 1.[laparoscopyhospital.com]
  • Treatment of the esophagus, stomach or duodenal ulcersaims to relieve pain, heal the ulcer, and prevent complications.[medicinenet.com]
  • Prevention Prompt and effective treatment of peptic ulcers will prevent chronic scarring and narrowing. Drugs developed over the past few decades have all but eliminated the need for ulcer surgery.[medical-dictionary.thefreedictionary.com]
  • Prevention No specific measures are recommended to prevent congenital anomalies that result in duodenal obstruction.[encyclopedia.com]
  • If NSAID therapy can be discontinued, it is recommended that the patient do so to prevent ulcer recurrence.[clinicaladvisor.com]

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