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Acute Peptic Ulcer

Signs & Symptoms

 Awakes from sleep #DU
Ref: Uptodate [ Clinical manifestations of peptic ulcer disease] Harrison [ 2202] Harrison [ 2227] Cecil [ 407] UMLS [ C0030920] Epocrates [ https://online.epocrates.com/diseases/8031/Peptic-ulcer-disease/Diagnostic-Approach]
Relief with anti secretory agents
Ref: Uptodate [ Clinical manifestations of peptic ulcer disease]
Increase of postprandial abdominal pain
Ref: Harrison [ 2227]
Worsens with eating #GU #Food-provoked_dyspepsia #Food-provoked_indigestion #gastric_outlet_obstruction
Ref: Uptodate [ Clinical manifestations of peptic ulcer disease] Cecil [ 407]

Physical Examination

 Board-like rigidity #perforation
Ref: Harrison [ 2227] Cecil [ 411]
Severe rebound tenderness #perforation
Ref: Harrison [ 2227] Cecil [ 411]
Guarding #perforation
Ref: Cecil [ 411]

Lab / Serology

 Elevated carcinoembryonic antigen
Ref: Uptodate [ Clinical manifestations, diagnosis, and staging of colorectal cancer]
Helicobacter pylori infection
Ref: Harrison [ 607]
Hypersecretion of gastric pepsin
Ref: Cecil [ 413]

Imagin Study

 Prominent gastric folds
Ref: Uptodate [ Clinical manifestations and diagnosis of Zollinger-Ellison syndrome (gastrinoma)] Harrison [ 607]
Ulcers with obstruction
Ref: Harrison [ 2238]
Ulcer recurrence after acid-reducing surgery
Ref: Harrison [ 2238]

Complication

 Increase of postprandial abdominal pain
Ref: Harrison [ 2227]
Prominent gastric folds
Ref: Uptodate [ Clinical manifestations and diagnosis of Zollinger-Ellison syndrome (gastrinoma)] Harrison [ 607]
Chronic unexplained diarrhea
Ref: Harrison [ 607] Cecil [ 1190]

Risk Factors

 NSAID intake
Ref: Epocrates [ https://online.epocrates.com/diseases/8032/Peptic-ulcer-disease/Risk-Factors]
Cigarette smoking
Ref: Epocrates [ https://online.epocrates.com/diseases/8032/Peptic-ulcer-disease/Risk-Factors]
Elder
Ref: Epocrates [ https://online.epocrates.com/diseases/8032/Peptic-ulcer-disease/Risk-Factors]

Cause

 annular pancreas
Ref: Harrison [ 2449]
Caused by annular pancreas
Ref: Harrison [ 2449]

Other