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Penetrating Duodenal or Gastric Ulcer


  • This program will present case studies for the patient who presents with anxiety, panic, depression, and mood disorders.[thenpa.org]
  • Treatment and prognosis Treatment depends on the clinical presentation.[radiopaedia.org]
  • TYPICAL AND ATYPICAL PRESENTATION OF PEPTIC ULCER Peptic Ulcer (1) TYPICAL PRESENTATION —more typical In duodenal ulcer but more confusing and not so typical in gastric ulcer.[homeomagnet.com]
  • That is why the clinical presentation of posterior gastric perforation is less dramatic than that of the more common anterior perforations and is characterized by late presentation.[ejs.eg.net]
Weight Loss
  • Maldigestion and steatorrhea caused by pancreaticobiliary bypass, especially with Billroth II anastomosis, may contribute to weight loss.[merckmanuals.com]
  • Other symptoms include nausea, vomiting, loss of appetite, weight loss and variation with eating (getting better or worse). When severe, peptic ulcer disease can lead to complications.[kzngastro.co.za]
  • This may cause bloating, feeling full after eating, vomiting, and weight loss.[medbroadcast.com]
  • This leads to weight loss, vomiting, and even death in severe cases. What causes peptic ulcer disease? Despite a common misconception, ulcers are not caused by spicy foods or stress. Instead, most ulcers are caused by a bacterial infection.[gothammedicine.com]
  • Over time, this scarring may close the outlet of the stomach, preventing food from passing into the small intestine and causing vomiting and weight loss. In severe cases, ulcer complications can lead to death.[gothamgastro.com]
  • Tick-borne Rickettsia rickettsii Rocky Mountain spotted fever Rickettsia conorii Boutonneuse fever Rickettsia japonica Japanese spotted fever Rickettsia sibirica North Asian tick typhus Rickettsia australis Queensland tick typhus Rickettsia honei Flinders[en.wikipedia.org]
  • Symptoms will then reappear with blood like rigidity of the abdominal wall associated with fever and signs of shock and general collapse. An acute perforation is a possible surgical emergency and needs quick medical or surgical attention.[medicalonline.com.au]
  • Case Report A 63 years old male presented to our emergency department with history of epigastric pain and fever of 3 weeks duration.[tropicalgastro.com]
  • As they mature from the larval state to the adult worm, roundworms migrate through the body, causing ascariasis , an infection characterized by fever , pneumonitis (lung inflammation), cholangitis (inflammation of the bile ducts), and pancreatitis .[britannica.com]
  • A perforated ulcer that spills stomach contents into the abdomen can produce radiating pain, difficulty breathing and fever. An ulcer that obstructs the opening to the small intestine may cause vomiting.[nmihi.com]
Abdominal Pain
  • Plain radiograph Abdominal films have little role in the setting of vague/chronic upper abdominal pain, and have a very low yield.[radiopaedia.org]
  • Can my upper abdominal pain be caused by other possibilities? Not all upper abdominal pain is due to peptic ulcer, gastritis or duodenitis. Your doctor can help you evaluate. Prevention Avoidance of prolonged NSAIDs is important.[singhealth.com.sg]
  • A 65-year-old man presents with a 1-week history of increasingly intense and continuous low abdominal pain that does not appear to be exacerbated by eating.[ueg.eu]
  • pain worse with eating.[medbullets.com]
  • About 15 percent to 20 percent of abdominal pains in children is due to peptic ulcer. Most primary peptic ulcer disease in children are seen in the ages between 8 and 17.[asianjournal.com]
Severe Abdominal Pain
  • abdominal pain worse with eating.[medbullets.com]
  • Clinical features The patient presents with sudden onset of severe abdominal pain. The onset of pain is so sudden that the patient can often accurately pin-point the exact moment when the perforation occurred.[surgwiki.com]
  • Severe abdominal pain, with or without evidence of bleeding, may indicate that the ulcer has perforated the stomach or duodenum.[stlukes-stl.com]
  • It usually appears as a sudden, severe abdominal pain, located in the epigastrium, which may radiate to back or become diffuse and associated with acute shock suggests a complicated ulcer perforation with peritonitis.[elynsgroup.com]
  • Initial symptoms of perforated duodenal or gastric ulcers include severe abdominal pain, worse in the epigastrium, often accompanied by nausea and vomiting. Typically the patient is acutely and severely ill.[intranet.tdmu.edu.ua]
Acute Abdomen
  • The patient presents with an acute abdomen. 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]
  • Free perforation: Free perforation usu ally presents as an acute abdomen. Ulcers that perforate the peritoneal cavity are usually located in the anterior wall of the duo denum or, less commonly, in the stomach.[intranet.tdmu.edu.ua]
Recurrent Abdominal Pain
  • Recurrent abdominal pain and other gastrointestinal symptoms are common in children, and it is becoming the norm for pediatricians to screen for H. pylori infection in children with these symptoms.[stlukes-stl.com]
Pancreatic Pain
  • Posterior wall perforation leads to pancreatitis ; pain in this situation often radiates to back. Penetration is when the ulcer continues into adjacent organs such as liver and pancreas [3] .[psychology.wikia.com]
Back Pain
  • Critical Essential Core Tested Community Questions (5) Sorry, this question is for PEAK Premium Subscribers only Sorry, this question is for PEAK Premium Subscribers only (M1.GI.4) A 41-year-old male who takes NSAIDs regularly for his chronic back pain[medbullets.com]
  • Back pain may suggest a penetrating posterior duodenal ulcer. Patients can present for the first time with either a haematemesis or melaena or with a perforation.[medassignments.com]
  • The doctor is more likely to suspect an ulcer if the patient has one or more of the following risk factors: male sex age over 45 recent weight loss, bleeding, recurrent vomiting, jaundice, back pain, or anemia history of using aspirin or other NSAIDs[medical-dictionary.thefreedictionary.com]
  • Ulcers that penetrate the back wall of the stomach or duodenum erode into the pancreas , and back pain becomes prominent. If the ulcer penetrates the anterior wall, free perforation into the abdominal cavity may occur.[britannica.com]


  • STIs) (1 CH & .50 PCH) During this presentation participants will learn about STIs epidemiology/trends and the recently released new Centers for Disease Control (CDC) STI Treatment Guidelines including changes in screening recommendations, diagnostic workup[thenpa.org]
  • Upper and lower gastrointestinal endoscopy examinations are performed daily as routine diagnostic procedures in a large number of patients with nonspecific indications, such as heartburn, pain, anaemia, bleeding, workup of portal hypertension and so on[ueg.eu]
Neisseria Gonorrhoeae
  • gonorrhoeae/gonococcus Gonorrhea ungrouped: Eikenella corrodens / Kingella kingae HACEK Chromobacterium violaceum Chromobacteriosis infection Burkholderiales Burkholderia pseudomallei Melioidosis Burkholderia mallei Glanders Burkholderia cepacia complex[en.wikipedia.org]


  • Accepted abstracts had to include at least 2 treatment arms, to specify the diagnosis of patients, the exact drug doses, the duration of treatment and method of eradication control (histology, culture, rapid urease test or 13 C-urea test).[wjgnet.com]
  • What is the treatment for peptic ulcers? Can they be cured? The goal of ulcer treatment is to relieve pain, heal the ulcer, and prevent complications. The first step in treatment involves the reduction of risk factors (NSAIDs and cigarettes).[medicinenet.com]
  • Treatment is with oral iron, which may be needed long-term.[medassignments.com]
  • It may also be used as adjunctive therapy in the treatment of peptic ulcer and in the treatment of the irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis.[drugs.ncats.io]
  • Treatment and Prevention Medical treatment focuses on eliminating the H. pylori bacteria in people where it has been detected.[medbroadcast.com]


  • Treatment and prognosis Treatment depends on the clinical presentation.[radiopaedia.org]
  • In the rare cases when surgery cannot be done, prognosis is poor. Gastric outlet obstruction Obstruction may be caused by scarring, spasm, or inflammation from an ulcer.[merckmanuals.com]
  • Prognosis The prognosis for recovery from ulcers is good for most patients. Very few ulcers fail to respond to the medications that are currently used to treat them. Recurrences can be eliminated completely or cut to 5% by eradication of H. pylori .[medical-dictionary.thefreedictionary.com]
  • It is an autosomal dominant disease with penetrance that is generally accepted to be 80%. [1] [20] Prognosis A 2009 study which followed 189 patients found no excess mortality despite the increased risk of pancreatic cancer. [21] References 1 2 Comfort[ipfs.io]
  • PROGNOSIS The prognosis for recovery from ulcers is good for most patients. Nearly all ulcers respond to the medications now used to treat them.[encyclopedia.com]


  • […] arrive Mucosal cell replication 14 Disruption of Gastric Mucosal Barrier Fig 15 Peptic Ulcer Disease Etiology and Pathophysiology When blood flow is not sufficient, tissue injury results 16 Peptic Ulcer Disease Etiology and Pathophysiology Two mechanisms[slideplayer.com]
  • The more frequent etiologies are NSAIDs, aspirin, or Helicobacter pylori infection [ 3 ]. Other unusual causes exist; one of which is described in our case report.[pancreas.imedpub.com]
  • The etiology of duodenitis is not completely understood. However, the gastric acid hypersecretion and the helicobacter pylori play an important role in the pathogenesis. Brunner Gland Hyperplasia.[gastrointestinalatlas.com]
  • Etiology of PUD However, we must remember that approximately 5-15% of patients considered Hp negative, despite performing wide comprehensive etiological studies, do not get to find again the precise cause of PU, which are referred to as "idiopathic”.[elynsgroup.com]


  • EPIDEMIOLOGY Duodenal ulceration is common; 15% of the population will suffer from a duodenal ulcer at some time. They are two to three times commoner than gastric ulcers.[medassignments.com]
  • Epidemiology It has a reported incidence of 1-4/1000, and is much more common in men (particularly duodenal ulcers- 5:1) Incidence has reduced in recent years due to widespread prescription of PPIs, awareness of NSAID use and risk, and eradication of[dundeemedstudentnotes.wordpress.com]
  • Time-trends in the epidemiology of peptic ulcer bleeding. Scand J Gastroenterol . 2005; 40 :914–20. 3. Sharma SS, Mamtani MR, Sharma MS, Kulkarni H.[tropicalgastro.com]
  • Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion 2011; 84:102-113. 4. Williams N, Bullstrode C, Connell RO.[ejs.eg.net]
  • Epidemiology of perforated peptic ulcer : age- and gender –adjusted analysis of incidence and mortality. World J Gastroenterol. 2013;19(3):347-54. (PMID: 23372356) Sandzen B, Rosenmüller M, Haapamäki M.M, Nilsson E, Stenlund H.C, Oman M.[pancreas.imedpub.com]
Sex distribution
Age distribution


  • […] replication 14 Disruption of Gastric Mucosal Barrier Fig 15 Peptic Ulcer Disease Etiology and Pathophysiology When blood flow is not sufficient, tissue injury results 16 Peptic Ulcer Disease Etiology and Pathophysiology Two mechanisms that protect Mucus[slideplayer.com]
  • […] the levels of these hormones increase) This increases acid causes increased cell turnover in the duodenum, metaplasia and eventually ulceration, particularly in those with other risk factors (it is not certain whether gastric ulcers follow the same pathophysiology[dundeemedstudentnotes.wordpress.com]
  • Nurse practitioners will gain an understanding of the pathophysiology of the immune system and current rise in prevalence of food allergy.[thenpa.org]
  • Pathophysiology: The duodenal mucosa resists damage from theeffect of aggressive factors, such as gastric acid and theproteolytic enzyme pepsin, with the help of several protectivefactors such as a mucous layer, bicarbonate secretion, andprotective prostaglandins[gastrointestinalatlas.com]
  • As a nurse providing care to a patient with peptic ulcer disease, it is important to know the signs and symptoms, pathophysiology, medications, nursing management, diet education, and complications.[registerednursern.com]


  • Original Article Nov 10, 2018 Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease Manson J.E., Cook N.R., Lee I.[nejm.org]
  • Eventually, we will understand how H.pylori is spread and how to prevent this infection. Meanwhile, the good news is that treatment programs are available to eliminate the infection and prevent duodenal recurrence.[maingastro.com]
  • Prevention Strategies for the prevention of ulcers or their recurrence include the following: eradication of H. pylori in patients already diagnosed with ulcers giving misoprostol to patients who must take NSAIDs avoiding unnecessary use of aspirin and[medical-dictionary.thefreedictionary.com]
  • Treatment of the esophagus, stomach or duodenal ulcersaims to relieve pain , heal the ulcer, and prevent complications.[medicinenet.com]
  • Kevin Letz, DNP, Redwood City, CA C15 Opioid Overdose Prevention (1 CH & .26 PCH) Opioid overdose constitutes a serious, preventable, life-threatening event.[thenpa.org]

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