Discussion Case Background: A 35-year old accountant presented to his physician
ID: 192514 • Letter: D
Question
Discussion Case Background: A 35-year old accountant presented to his physician with a steady burning pain just right of the mid-line of the abdominal region in an area from 1 to 4 inches above the "belly button." The pain usually followed meals by about 1-3 hours. He had several episodes of vomiting, which included frank blood. On physical examination, the patient had no fever. He appeared generally well. He had no evidence of weight loss. He showed slight rebound tenderness in the upper abdomen. An occult blood test revealed the presence of blood.Explanation / Answer
1.This case may be diagnosed as Gastric ulcer,occult bleeding.Stomach is located in the upper middle portion of the abdomen.As there is acid secretion in the inner walls of the stomach causing acidity no microbes can infect the stomach except the bacterium Helicobacter pylori which can cause Gastrooesophageal Reflux disease,burping,pain,blood while vomiting.I would suggest for an endoscopy and biopsy.Other risk factor include-Gastric cancer.
2.Helicobacterer pylori whic is found in majority of people with peptic ulcer.
3.Testing and Treatment:
H.pyroli is treated with Bismuth compounds(using proton pump inhibitor like nexium) and antibiotic therapy,The monitoring of bleeding is done,
Clinical Treatment include Endoscopy for studying the staging of ulceration and suggest for surgery if extensive.