Signs and symptoms:
Gnawing or burning, nonradiating, recurring pain that is often episodic
Relieved by food or antacids
PPIs have higher efficacy than H2 blockers. 95% of duodenal ulcers heal on PPI therapy within 4 weeks.
Omeprazole 20 mg/day PO; lansoprazole 30 mg/day PO; ...
H. pylori eradication: expected in >90% (with double antibiotic regimen): Confirm eradication with urea breath test or fecal antigen test.
K27.9 Peptic ulc, site unsp, unsp as ac or chr, w/o hemor or perf
K26.9 Duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation
K25.9 Gastric ulcer, unspecified as ...
PPIs have higher efficacy than H2 blockers for healing duodenal ulcers.
In patients with PUD, eradicate H. pylori to assist healing and reduce the risk of recurrence.
Upper endoscopy is ...
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<bold><italic>Figure 15-14</bold> Perforated peptic ulcer of stomach.</bold>
Gastric ulcer. The stomach has been opened to reveal a sharply demarcated, deep peptic ulcer on the lesser curvature.
Duodenal ulcer. A sharply punched-out peptic ulcer of the duodenum is situated immediately below the pylorus.
<bold>Fig GI 10-10 Peptic ulcer disease.</bold> (A) Large incisura (black arrow) simulating a filling defect on the greater curvature. The incisura is incited by a long ulcer (white arrows) on the lesser curvature. (B) Double pylorus. The true pylorus and the accessory channel along the lesser curvature are separated by a bridge, or septum, that produces the appearance of a discrete lucent filling defect (arrow).
<bold>Fig GI 10-10 Peptic ulcer disease.</bold> (A) Large incisura (black arrow) simulating a filling defect on the greater cu...