消化性溃疡英文病历

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1、消化性溃疡英文病历A37-year-oldexecutivereturnstoyourofficeforfollowupofrecurrentupperabdominalpain.Heinitiallypresented6weeksago,complainingofanincreaseinfrequencyandseverityofburningepigastricpain,whichhe'shadoccasionallyformorethan2years.Henowhasthepainthreeorfourtime

2、saweek,usuallyonanemptystomach,anditoftenawakenshimatnight.Thepainisusuallyrelievedwithinminutesbyfoodorover-the-counterantacids,butrecurswithin2-3hours.Headmittedthatstressatworkhadrecentlyincreasedandthatbecauseoflongworkinghours,hewasdrinkingmorecaffeineand

3、eatingalotof"take-out"foods.Hispastmedicaihistoryandreviewofsystemswereotherwiseunremarkable,andotherthantheantacids,hetakesnomedications.Hisphysicalexamwasnormal,includingstoolguaiacthatwasnegativeforoccultblood.YouadvisedachangeindietandstartedhimonanH:-bloek

4、er.Hissymptomsresolvedcompletelywiththedietchangesanddailyuseofthemedication.Labtestsdoneathisfirstvisitshowsnoanemia,buthisserumHelicobacterpyloriantibodytestwaspositive.+Whatisyourdiagnosis?+Whatisyourneststep?ANSWERS:PepticUlcerDiseaseSummary:A37-year-oidman

5、presentscomplainingofchronicandrecurrentupperabdominalpainwithcharacteristicssuggestiveofduodenalulcer:thepainisburninginquality,occurswhenthestomachisempty,andisrelievedwithinminutesbyfoodorantacids.Hedoesnothaveevidenceofgastrointestinalbleedingoranemia.Hedo

6、esnottakenonsteroida!antiinflammatorydrugs,whichmightcauseulcerformation,buthedoeshaveserologicalevidenceofH.pyloriinfection.♦Mostlikelydiagnosis:Pepticulcerdisease.♦Nextstep;AntibiotictherapyforKpyloriinfection.AnalysisObjectives1.Knowhowtodifferentiatecommon

7、causesofabdominalpainbyhistoricalclues.141.Recognizeclinicalfeaturesofduodenalulcer,gastriculcer,andfeaturesthatincreaseconcernforgastriccancer.2.UnderstandtheroleofHelicobacterpyloriinfectionanduseofNSAIDsintheetiologyofpepticulcerdisease.3.Understandtheusea

8、ndinterpretationoftestsforH.pylori.ConsiderationsInthispatient,thesymptomsaresuggestiveofduodenalulcer.Hedoesnothave"alarmsymptoms"suchasweightloss,bleedingoranemia,andhisyo