Disease Information for Penetrating duodenal ulcer

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Clinical Manifestations
Signs & Symptoms
Acute Chest Pain in Children
Abdominal Pain
Abdominal pain after meals/eating food
Abdominal Pain in Children
Abdominal pain Radiates to Back
Abdominal pain/epigastric radiates to back
Abdominal pain/Improves fasting
Acute abdomen
Acute abdomen with no signs
Chronic Abdominal Pain
Cibaphobia/Fear of Eating
Epigastric Pain
Epigastric pain/unrelieved by antacid
Epigastric recurrent pain attacks
Epigastric tenderness
Nocturnal abdominal pain
Peptic ulcer like pain
Recurrent Abdominal Pain
Retroperitoneal/Gut area Pain
Severe abdominal pain
Steady abdominal pain
Upper Abdominal Pain
Vomiting blood/hematemesis
Pancreatic pain syndrome
Pancreatic symptoms/signs
Acute Back Pain
Back Pain
Back Pain Severe
Backache
Mid-back pain
Costovertebral Angle Pain/Tenderness
Flank Pain
Fever
Fever Febrile Possible
Flu-Like Syndrome
High body temperature
Nocturnal awakenings Events Phenomenon
Weight Loss
Clinical Presentation & Variations
Presentation/Pancreatitis Kids Recurrent
Disease Progression
Course/Chronic disorder
Course/Chronic only
Demographics & Risk Factors
Established Disease Population
Patient/Peptic ulcer disease
Sex & Age Groups
Population/Male
Laboratory Tests
Abnormal Lab Findings (Non Measured)
Acute inflammatory markers elevated (Lab)
Abnormal Lab Findings - Increased
Amylase, serum (Lab)
Diagnostic Test Results
Other Tests & Procedures
Gastroscopy/Abnormal
CT Scan
CT Scan/CTA Abdomen Abnormal
X-RAY With contrast
UGI/Abnormal
UGI/Gastric wall/air interstitial
UGI/Gastroduodenal fistula
Associated Diseases & Rule outs
Rule Outs
Dissecting aortic aneurysm
Pancreatitis, acute
Peptic ulcer disease
Associated Disease & Complications
Duodenal Stenosis
Fistula, Gastroduodenal
Gastroduodenal perforation
Gastrointestinal bleeding
Hyperamylasemia
Pancreatitis, acute
Peptic ulcer hemorrhage
Perforated viscus
Peritonitis. acute
Portal vein thrombosis
Upper GI bleeding
Disease Mechanism & Classification
Class
CLASS/Duodenum involvement/disorder (ex)
CLASS/Intestinal/stomach/gut (category)
Pathophysiology
Pathophysiology/Ulcer/gut disorder (ex)
Process
PROCESS/Structural/anatomic/foreign body (category)
Treatment
Drug Therapy - Indication
RX/Anti-H2 receptor medication
RX/Gastric proton pump inhibitor
SX/Laparotomy
Surgical Procedures or Treatments
SX/Surgery
SX/Surgical emergency
Other Treatments
TX/Medical/surgical emergency
Definition

What Are the Complications of Peptic Ulcers?

Most ulcers can be cured without complications; However, in some cases, peptic ulcers can develop potentially life-threatening complications, such as penetration, perforation, bleeding (hemorrhage), and obstruction; Penetration:An ulcer can go through (penetrate) the muscular wall of the stomach or duodenum (the first segment of the small intestine) and continue into an adjacent organ, such as the liver or pancreas; This penetration causes intense, piercing, persistent pain, which may be felt outside of the area involved—for example, the back may hurt when a duodenal ulcer penetrates the pancreas; The pain may intensify when the person changes position; If drugs do not heal the ulcer, surgery may be needed; Perforation: Ulcers on the front surface of the duodenum, or less commonly the stomach, can go through the wall, creating an opening (perforation) to the free space in the abdominal cavity; The resulting pain is sudden, intense, and steady; The pain rapidly spreads throughout the abdomen; The person may feel pain in one or both shoulders, which may intensify with deep breathing; Changing position worsens the pain, so the person often tries to lie very still; The abdomen is tender when touched, and the tenderness worsens if a doctor presses deeply and then suddenly releases the pressure; (Doctors call this rebound tenderness; ) Symptoms may be less intense in older people, in people taking corticosteroids, or in very ill people; A fever indicates an infection in the abdominal cavity; If the condition is not treated, shock may develop; This emergency situation requires immediate surgery and intravenous antibiotics;

--------------------[Merck Manual/website 2007]------------------------------

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External Links Related to Penetrating duodenal ulcer
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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