Histopathologically Confirmed Duodenitis Not Associated with Peptic Ulcer in the Pathogenesis of Upper Abdominal Pain

2018 ◽  
Vol 6 (2) ◽  
pp. 7
Author(s):  
Ashok Gopinath ◽  
SM Raja Pradeep
Keyword(s):  
Peptic Ulcer ◽  
Abdominal Pain ◽  
Upper Abdominal

Cimetidine and non-ulcer dyspepsia

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?

Acute pancreatitis

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....

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

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

Enterogastric Reflux: an Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (2) ◽  
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.

scholarly journals Foreign Body in abdomen

2015 ◽  
Vol 14 (2) ◽  
pp. 210-212
Author(s):  
Md Zakirul Alam ◽  
Mohibul Aziz
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Medical Science ◽  
X Ray ◽  
Diagnostic Center ◽  
History Of ◽  
Upper Abdominal ◽  
Married Female

A 19 years old married female presented with severe upper abdominal pain, repeated vomiting having history of swallowing a knife 7 months ago was admitted in Mordern Clinic and Diagnostic center, Joypurhat, Bangladesh. USG abdomen & X-ray (fig-1) abdomen were done when presence of a large foreign body (knife fig-3) in abdomen was made which latter on confirmed by Endoscopy of upper GIT (fig-2). Surprisingly the patient kept it in her abdomen for 7 months without any symptoms until the symptoms got worse and compelled her to seek medical help. The knife was removed by laparotomy, gastrotomy with uneventful recovery.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.210-212

Unusual case of hyperemesis in a pregnant patient with prior antireflux surgery

2021 ◽  
Vol 14 (8) ◽  
pp. e241935
Author(s):  
Abimbola Obisesan ◽  
Eleanor Lucy Townsend ◽  
John Lin Hieng Wong ◽  
Vinod Menon
Keyword(s):  
Decision Making ◽  
Abdominal Pain ◽  
Antireflux Surgery ◽  
Unusual Case ◽  
Nissen Fundoplication ◽  
Hyperemesis Gravidarum ◽  
Pregnant Patient ◽  
Emergency Laparotomy ◽  
Laparoscopic Nissen ◽  
Upper Abdominal

A 33-year-old, 8 weeks pregnant, presented with severe upper abdominal pain with vomiting on a background of a previous laparoscopic Nissen fundoplication for reflux disease. An urgent MRI had shown herniation of the fundoplication wrap through the diaphragmatic hiatus. The cause of her symptoms was attributed to hyperemesis gravidarum. The plan was to manage this patient conservatively until the conclusion of her pregnancy. This plan was revised when she presented for the second time and developed worsening pain and haematemesis. An emergency gastroscopy showed ischaemic changes in most of the stomach requiring the patient to undergo an emergency laparotomy. In pregnant patients, presenting with abdominal pain, vomiting as well as haematemesis, having had previous antireflux surgery, incarceration of the stomach must be considered as a differential. Prompt assessment and early senior decision-making is extremely important in avoiding a potentially catastrophic outcome for such patients.

Fulminant varicella hepatitis: a rare but lethal cause of abdominal pain

2021 ◽  
Vol 14 (9) ◽  
pp. e244081
Author(s):  
Christopher Fang ◽  
Junice Wong ◽  
Wei Wen Ang
Keyword(s):  
Abdominal Pain ◽  
Hepatitis A ◽  
Case Reports ◽  
Antibody Testing ◽  
Salient Points ◽  
Vesicular Rash ◽  
History Of ◽  
Laboratory Investigations ◽  
The Common ◽  
Upper Abdominal

An 81-year-old woman with no history of immunocompromise presented with 2 days of upper abdominal pain associated with nausea. On arrival, her physical examination was unremarkable apart from mild epigastric and right hypochondriac tenderness, and laboratory investigations were unremarkable apart from mild thrombocytopenia and transaminitis. A CT scan performed on the day of admission revealed a tiny 0.3 cm stone in the common bile duct, with no upstream dilatation. On day 2 of admission, she developed a vesicular rash and with acutely worsening transaminitis. She deteriorated rapidly and demised from complications of acute liver failure within the next 24 hours. The diagnosis of varicella was confirmed with antibody testing. Fulminant varicella hepatitis is an extremely rare and lethal condition with only a handful of reported cases in the current literature. We aim to share our clinical experience and summarise the salient points from existing case reports.

scholarly journals Fingerprinting Acute Digestive Diseases by Untargeted NMR Based Metabolomics

2018 ◽  
Vol 19 (11) ◽  
pp. 3288 ◽  
Author(s):  
Panteleimon Takis ◽  
Antonio Taddei ◽  
Riccardo Pini ◽  
Stefano Grifoni ◽  
Francesca Tarantini ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
1H Nmr ◽  
Intestinal Ischemia ◽  
Principal Component ◽  
Disease Diagnosis ◽  
Proton Nuclear Magnetic Resonance ◽  
Mechanical Obstruction ◽  
Symptomatic Gallstones ◽  
Symptom Group ◽  
Upper Abdominal

Precision medicine may significantly contribute to rapid disease diagnosis and targeted therapy, but relies on the availability of detailed, subject specific, clinical information. Proton nuclear magnetic resonance (1H–NMR) spectroscopy of body fluids can extract individual metabolic fingerprints. Herein, we studied 64 patients admitted to the Florence main hospital emergency room with severe abdominal pain. A blood sample was drawn from each patient at admission, and the corresponding sera underwent 1H–NMR metabolomics fingerprinting. Unsupervised Principal Component Analysis (PCA) analysis showed a significant discrimination between a group of patients with symptoms of upper abdominal pain and a second group consisting of patients with diffuse abdominal/intestinal pain. Prompted by this observation, supervised statistical analysis (Orthogonal Partial Least Squares–Discriminant Analysis (OPLS-DA)) showed a very good discrimination (>90%) between the two groups of symptoms. This is a surprising finding, given that neither of the two symptoms points directly to a specific disease among those studied here. Actually herein, upper abdominal pain may result from either symptomatic gallstones, cholecystitis, or pancreatitis, while diffuse abdominal/intestinal pain may result from either intestinal ischemia, strangulated obstruction, or mechanical obstruction. Although limited by the small number of samples from each of these six conditions, discrimination of these diseases was attempted. In the first symptom group, >70% discrimination accuracy was obtained among symptomatic gallstones, pancreatitis, and cholecystitis, while for the second symptom group >85% classification accuracy was obtained for intestinal ischemia, strangulated obstruction, and mechanical obstruction. No single metabolite stands up as a possible biomarker for any of these diseases, while the contribution of the whole 1H–NMR serum fingerprint seems to be a promising candidate, to be confirmed on larger cohorts, as a first-line discriminator for these diseases.

scholarly journals Acute Pancreatitis: An Atypical Presentation

2017 ◽  
Vol 11 (2) ◽  
pp. 359-363 ◽  
Author(s):  
Omar Nadhem ◽  
Omar Salh
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Reports ◽  
Case Series ◽  
Normal Serum ◽  
Intravenous Fluids ◽  
Serum Enzyme ◽  
Serum Lipase ◽  
Upper Abdominal ◽  
Symptoms And Signs

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.

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