Considered an important cause of PU

Another common cause of PU

smoking

genetics

Acute stress can cause stress ulcers

Abnormal movement of stomach and duodenum

pain characteristics

Nature and location of pain

compound ulcer

retrobulbar ulcer

huge ulcer

peptic ulcer in the elderly

asymptomatic ulcer

It is the most common complication of peptic ulcer, and ulcer is the most common cause of gastrointestinal bleeding.

Free perforation can cause acute diffuse peritonitis

Penetrating ulcer, the organ most commonly penetrated is the pancreas

subacute perforation

fistula

Typical clinical manifestations of acute perforation

Abdominal X-ray examination reveals free air shadow under the diaphragm, which is an important basis for diagnosing perforation.

It is mostly caused by congestion, edema and pyloric spasm of the tissue around the ulcer. It is relieved as the inflammation improves and is called temporary and functional obstruction.

Chronic obstruction is persistent primarily due to scar shrinkage

Pain worsens after meals, accompanied by nausea and vomiting, which can lead to dehydration and hypokalemia and hypochloremic alkalosis.

A small number of GU can become cancerous, but DU does not.

I have a long-term history of chronic GU. I am 45 years old. The ulcer is stubborn and does not heal. I should be alert to cancer.

Is the preferred method for diagnosing peptic ulcer

It often presents with upper abdominal fullness and belching, which is aggravated after eating, and does not have the characteristics of rhythmic pain of peptic ulcer. However, PU is often complicated by chronic gastritis. When identification is difficult, gastroscopy can be used to confirm the diagnosis.

Symptoms such as upper abdominal distension and pain, acid reflux, belching, burning sensation, nausea, vomiting, and loss of appetite are common, and they resemble atypical ulcers. The identification relies on gastroscopy and X-ray barium meal.

Right upper abdominal pain radiating to the right shoulder and back may occur after eating greasy food, which may be accompanied by fever, jaundice, and a positive Murphy sign. Abdominal B-ultrasound, MRCP, ERCP assist in diagnosis

Ulcers are generally larger and irregular in shape

The bottom is uneven and the moss is dirty

The edge of the ulcer is nodular and raised

middle section of surrounding wrinkled wall

Stomach wall stiffness and weakened peristalsis

Treatment to eradicate H pylori

Inhibit gastric acid secretion

Drugs to protect gastric mucosa

Treatment of Ulcers with NSAIDs

① Massive bleeding that fails medical treatment

②Acute perforation

③Cicatricial pyloric obstruction

gastric ulcer cancer

Intractable ulcers that fail to respond to strict medical treatment