The Role of Endoscopically Confirmed Duodenitis not Associated with Peptic Ulcer in the Pathogenesis of Upper Abdominal Pain: A Prospective Hospital Based Study

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

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Cimetidine and non-ulcer dyspepsia

Drug and Therapeutics Bulletin ◽

10.1136/dtb.24.1.3 ◽

1986 ◽

Vol 24 (1) ◽

pp. 3-4

Keyword(s):

Peptic Ulcer ◽

Abdominal Pain ◽

Gastric Acid ◽

Reflux Oesophagitis ◽

Data Sheet ◽

Organic Disease ◽

Dyspeptic Symptoms ◽

Proven Efficacy ◽

Non Ulcer Dyspepsia ◽

Upper Abdominal

Many patients with dyspepsia do not appear to have organic disease.1 Cimetidine (Tagamet) is of proven efficacy in the treatment of peptic ulcer and reflux oesophagitis, but is widely used for the treatment of dyspepsia without investigation.2, 3 The data sheet for cimetidine now states that the drug is indicated “where reduction of gastric acid by Tagamet has been shown to be beneficial: persistent dyspeptic symptoms with or without ulceration, particularly meal-related upper abdominal pain”. Is this indication valid?

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Acute pancreatitis

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.152401_update_001 ◽

2010 ◽

pp. 2557-2567

Author(s):

R. Carter ◽

C.J. McKay

Keyword(s):

Acute Pancreatitis ◽

Peptic Ulcer ◽

Gastric Ulcer ◽

Abdominal Pain ◽

Serum Amylase ◽

Perforated Peptic Ulcer ◽

Upper Limit ◽

Abdominal Emergencies ◽

Idiopathic Acute Pancreatitis ◽

Upper Abdominal

Acute pancreatitis affects 300 to 600 new patients per million population per year and is most commonly caused by gallstones or alcohol, but there are many other causes and associations. Careful imaging reveals that most so-called idiopathic acute pancreatitis is due to small (1–3 mm diameter) gallstones. Diagnosis is made by a combination of a typical presentation (upper abdominal pain and vomiting) in conjunction with raised serum amylase (> × 3 upper limit of normal) and/or lipase (> × 2 upper limit of normal). Several acute abdominal emergencies can mimic acute pancreatitis and may be associated with a raised serum amylase. These include perforated peptic ulcer (particularly perforated posterior gastric ulcer) and acute mesenteric ischaemia. In equivocal cases, a CT scan is indicated in order to exclude other causes and confirm the diagnosis....

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Enterogastric Reflux: An Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

Journal of Case Reports in Medicine ◽

10.25149/jcrm.v8i3.219 ◽

2019 ◽

Vol 8 (3) ◽

Author(s):

Peter Wang

Keyword(s):

Abdominal Pain ◽

Digestive Enzymes ◽

Gallbladder Disease ◽

Hepatobiliary Scintigraphy ◽

Hepatobiliary Imaging ◽

Upper Gi ◽

Gi Symptoms ◽

Upper Abdominal ◽

Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

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Role of Cholecystectomy in Symptomatic Hyperkinetic Gallbladder Patients

Case Reports in Surgery ◽

10.1155/2021/5569850 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

Jai P. Singh

Keyword(s):

Abdominal Pain ◽

Complete Resolution ◽

Biliary Colic ◽

Quadrant Pain ◽

Gallbladder Ejection Fraction ◽

Hida Scan ◽

Upper Abdominal ◽

The Right ◽

Upper Abdomen

Introduction. Biliary dyskinesia is defined by a gallbladder ejection fraction (EF) of less than 35% on HIDA scan, and these patients have shown a good response to cholecystectomy. Management of patients with biliary colic symptoms who have a hyperkinetic gallbladder ( EF > 80 % ) is not clearly defined. Herein, I report three cases of the symptomatic hyperkinetic gallbladder that were successfully managed with cholecystectomy. Case Report. Patient 1was a 56-year-old female presented with pain in the right upper abdomen for one month. Her workup was unremarkable except for the gallbladder EF of 86%. Patient 2 was a 33-year-old female with similar symptoms and workup with gallbladder EF of 97%. Patient 3 was a 20-year-old female with right upper abdominal pain and gallbladder EF of 91%. Patients 1 and 3 had the normal US, normal CT scan, and normal EGD. Patient 2 had normal US and CT but did not undergo EGD. All three patients underwent laparoscopic cholecystectomy and had complete resolution of their symptoms. Conclusion. The hyperkinetic gallbladder is a rare phenomenon, which can cause debilitating right upper quadrant pain. All three patients had an excellent response to cholecystectomy. Therefore, it is concluded that the patients with biliary colic and gallbladder EF of 80% or higher should be strongly considered for surgery.

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The Role of Celiac Plexus Block in Intractable Upper Abdominal Pain

Techniques of Neurolysis - Current Management of Pain ◽

10.1007/978-1-4899-6721-3_14 ◽

1989 ◽

pp. 161-169 ◽

Cited By ~ 2

Author(s):

Subhash Jain

Keyword(s):

Abdominal Pain ◽

Celiac Plexus ◽

Celiac Plexus Block ◽

Upper Abdominal ◽

Plexus Block

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Peptic Ulcer Disease and Misuses of Ulcer Healing Drugs in a Tertiary Care Hospital in Dhaka City

Journal of Medicine ◽

10.3329/jom.v16i1.22386 ◽

2015 ◽

Vol 16 (1) ◽

pp. 27-34

Author(s):

Md. Hafiz Md. Hafiz Sardar ◽

Mohammad Murad Hossain ◽

Khan Abul Kalam Azad ◽

Md Uzzwal Mallik ◽

Moumita Chakraborty

Keyword(s):

Peptic Ulcer ◽

Abdominal Pain ◽

Peptic Ulcer Disease ◽

College Hospital ◽

Female Ratio ◽

Ulcer Disease ◽

Medical College ◽

Non Ulcer Dyspepsia ◽

Irritable Bowel ◽

Upper Abdominal

This prospective cross sectional study was conducted in Dhaka Medical College Hospital, Dhaka during July, 2013 to December, 2013. Hundred patients were included in this study. Peptic ulcer disease, presented as upper abdominal pain is one of the common disease with a number of underlying causes. Prospective analyses of 100 patients with upper abdominal pain were studied at medicine units of Dhaka Medical College Hospital, Dhaka. Of these 36 patients belonged to peptic ulcer, 20 patients to irritable bowel syndrome and 22 patients to non-ulcer dyspepsia. Next in order were helminthiasis (5 patients), cholelithiasis (4 patients), gastric carcinoma (4 patients), liver abscess (5 patients) chronic pancreatitis (3 patients) and acute pancreatitis (1 patient). Mean age incidence in this series was 39.47 years. Male and female ratio was 1.54:1. Forty patients were smoker with male and female ratio of 3.44:1.All patients had presenting feature of upper abdominal pain. Commonest site of pain was in the epigastrium in 48.08% of cases.Pain was burning in 43.27% cases, periodic pain in 24.03%, and nocturnal hunger pain in 33.65% of cases.Relief of pain after taking food were observed in 38.46%. Epigastric tenderness was present in 56.73% patients.The diagnosis of peptic ulcer disease, irritable bowel syndrome and non-ulcer dyspepsia, the three leading causes of upper abdominal pain, were suspected by history and physical examination but it was difficult to interpret these on clinical ground alone .Some routine and some selected investigation were done for confirmatory diagnosis.In this series, significant disparity detected between clinically diagnosed peptic ulcer diseases 90.38% and endoscopically confirmed peptic ulcer disease, 34.62% cases. As a consequence of wrong diagnosis of PUD, there are huge misuses of ulcer healing drugs and a great economic burden on patients (300 taka per month) and on the nation.DOI: http://dx.doi.org/10.3329/jom.v16i1.22386 J MEDICINE 2015; 16 : 27-34

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