Peptic Ulcer Disease Flashcards
Peptic Ulcer Disease Gold standard method of investigation
Endoscopy (gastroduodenoscopy)
- Picture will be inflammatory process around the ulcer & appearance of ulcer will be bright (edematous)
Can patient die from PUD?
Yes, due to peritonitis & sepsis
5 complications of PUD
- Perforation (M/C)
- Penetration (infiltrates in other tissues/muscles/organs)
- Bleeding
- Stenosis
- Malignancy
Perforation in PUD
Standard method of investigation is X-ray w/o contrast (cheap, fast).
*Findings: Free gas inside the abdomen
a. Front wall: perforated
b. Back wall: Massive Hemorrhage
Types of ulcers and their most common symptoms
Types:
1. Duodenal ulcer (meal brings relief)
2. Gastric ulcer (meal worsens pain)
M/C symptoms:
a. Bleeding
b. Hematuria
c. Melena
Two clinical periods of PUD
- Exacerbation
- Remission (scar of ulcer - on endoscopy)
What is the disaster in Abdominal Trauma and what is the diagnostic method?
Diagnostic method: US
Disaster in Abdominal trauma is due to 2 outcomes:
1. Hemorrhage
2. Peritonitis
*Both are life-threatening conditions
Clinical Picture & diagnostic methods of Bleeding from upper part of abdomen vs. lower part of abdomen
Upper part: (Gastroduodenoscopy)
1. Hemoptysis
2. Coffee-like
3. Weakness (low bp)
4. Pale skin
5. Melena
6. Tachycardia
7. Bright CP
Lower part: (Colonoscopy)
1. No vomiting
2. Bloody stool
3. CP is not bright
4. No drop in bp
5. Not high tachycardia
6. H/s of PUD
Forest Classification for PUD (clinical endoscopic classification due to upper bleeding (caused by PUD)
- Forest 1 (endoscopy: active bleeding ulcer)
a. Active arterial bleeding
b. Venous bleeding/ blood oozing from the bottom of ulcer - Forest 2: Ulcer stopped bleeding
a. Side of ulcer, the artery/vessel is occluded/closed with thrombus, absent bleeding, possibility of rebleeding
a. Ulcer covered with clot, no active bleeding, possibility of rebleeding - Forest 3: There was bleeding, bleeding stopped, possibility of rebleeding is low because ulcer is covered with fibrin.
