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==Overview== | ==Overview== | ||
Peptic ulcer disease patient appears in severe stress due to [[abdominal pain]]. Common physical examination findings of peptic ulcer disease include epigastric tenderness, [[tachycardia]].Perforated peptic ulcer disease patient presents with classic triad of severe epigastric tenderness, [[tachycardia]], and abdominal rigidity. Clinical signs of perforated peptic ulcer | Peptic ulcer disease patient appears in severe stress due to [[abdominal pain]]. Common physical examination findings of peptic ulcer disease include epigastric tenderness, [[tachycardia]].Perforated peptic ulcer disease patient presents with classic triad of severe epigastric tenderness, [[tachycardia]], and abdominal rigidity. Clinical signs of perforated peptic ulcer occurs in 3 stages: In the initial stage within first 2 hours, the patient presents with [[tachycardia]], [[epigastric pain]] and [[cool extremities]].In next 2 to 12 hours, the patient presents with lower right quadrant tenderness and [[abdominal rigidity]]. In more than 12 hours, the patient presents with [[abdominal distension]], [[hypotension]], and [[pyrexia]] with [[acute circulatory collapse]].<ref>{{cite journal |vauthors=Chung KT, Shelat VG |title=Perforated peptic ulcer - an update |journal=World J Gastrointest Surg |volume=9 |issue=1 |pages=1–12 |year=2017 |pmid=28138363 |pmc=5237817 |doi=10.4240/wjgs.v9.i1.1 |url=}}</ref> | ||
==Physical Examination== | ==Physical Examination== | ||
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===HEENT=== | ===HEENT=== | ||
* Pallor on the lower conjunctiva can be seen. | * Pallor on the lower [[conjunctiva]] can be seen. | ||
===Lungs=== | ===Lungs=== | ||
* Normal B/L vesicular breath sounds. | * Normal B/L vesicular [[breath sounds.]] | ||
===Heart=== | ===Heart=== | ||
*S1 and S2 normal ,no murmur/rubs/gallops. | *S1 and S2 normal ,no murmur/rubs/gallops. | ||
===Abdomen=== | ===Abdomen=== | ||
*Abdominal tenderness at the epigastrium | *[[Abdominal tenderness]] at the epigastrium | ||
*Perforated peptic ulcer presents with<ref>{{cite journal |vauthors=Bertleff MJ, Lange JF |title=Perforated peptic ulcer disease: a review of history and treatment |journal=Dig Surg |volume=27 |issue=3 |pages=161–9 |year=2010 |pmid=20571260 |doi=10.1159/000264653 |url=}} </ref> | *Perforated peptic ulcer presents with<ref>{{cite journal |vauthors=Bertleff MJ, Lange JF |title=Perforated peptic ulcer disease: a review of history and treatment |journal=Dig Surg |volume=27 |issue=3 |pages=161–9 |year=2010 |pmid=20571260 |doi=10.1159/000264653 |url=}} </ref> | ||
**Rebound tenderness | **[[Rebound tenderness]] | ||
**Decreased bowel | **Decreased [[bowel sound]]<nowiki/>s | ||
**Lower right quadrant tenderness | **Lower right quadrant tenderness | ||
**Abdominal rigdity | **Abdominal rigdity | ||
**Abdominal distension <ref>{{cite journal |vauthors=Chung KT, Shelat VG |title=Perforated peptic ulcer - an update |journal=World J Gastrointest Surg |volume=9 |issue=1 |pages=1–12 |year=2017 |pmid=28138363 |pmc=5237817 |doi=10.4240/wjgs.v9.i1.1 |url=}}</ref> | **[[Abdominal distension]] <ref>{{cite journal |vauthors=Chung KT, Shelat VG |title=Perforated peptic ulcer - an update |journal=World J Gastrointest Surg |volume=9 |issue=1 |pages=1–12 |year=2017 |pmid=28138363 |pmc=5237817 |doi=10.4240/wjgs.v9.i1.1 |url=}}</ref> | ||
==References== | ==References== | ||
Latest revision as of 13:13, 23 October 2017
Template:Physical examination of peptic ulcer disease
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
Peptic ulcer disease patient appears in severe stress due to abdominal pain. Common physical examination findings of peptic ulcer disease include epigastric tenderness, tachycardia.Perforated peptic ulcer disease patient presents with classic triad of severe epigastric tenderness, tachycardia, and abdominal rigidity. Clinical signs of perforated peptic ulcer occurs in 3 stages: In the initial stage within first 2 hours, the patient presents with tachycardia, epigastric pain and cool extremities.In next 2 to 12 hours, the patient presents with lower right quadrant tenderness and abdominal rigidity. In more than 12 hours, the patient presents with abdominal distension, hypotension, and pyrexia with acute circulatory collapse.[1]
Physical Examination
Appearance of the Patient
- Patient usually appear in severe distress due to severe abdominal pain.
Vital Signs
- Patient has normal vital signs in initial stages of peptic ulcer.
- In peptic ulcer perforations vital signs may include :[2]
- Tachycardia with regular pulse
- Weak pulse
- low blood pressure with normal pulse pressure
- High-grade fever is present at later stage of peptic ulcer perforation
Skin
- Pallor is present in patients presents with hematemesis and melena.
-
![Source- Dr Graham Beards (Own work) [3]](/images/f/f2/Iron_deficiency_anemia_blood_film.jpg)
Source- Dr Graham Beards (Own work) [3]
-
![The hand of a person with severe anemia (on the left) compared to one without (on the right) Source -James Heilman, MD - Own work[4]](/images/1/1f/Anemia.jpg)
The hand of a person with severe anemia (on the left) compared to one without (on the right) Source -James Heilman, MD - Own work[4]
![Source- Dr Graham Beards (Own work) [3]](/index.php/File:Iron_deficiency_anemia_blood_film.jpg)
![The hand of a person with severe anemia (on the left) compared to one without (on the right) Source -James Heilman, MD - Own work[4]](/index.php/File:Anemia.jpg)
HEENT
- Pallor on the lower conjunctiva can be seen.
Lungs
- Normal B/L vesicular breath sounds.
Heart
- S1 and S2 normal ,no murmur/rubs/gallops.
Abdomen
- Abdominal tenderness at the epigastrium
- Perforated peptic ulcer presents with[5]
- Rebound tenderness
- Decreased bowel sounds
- Lower right quadrant tenderness
- Abdominal rigdity
- Abdominal distension [6]
References
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- For information on how to add references into your page, click here.
- ↑ Chung KT, Shelat VG (2017). "Perforated peptic ulcer - an update". World J Gastrointest Surg. 9 (1): 1–12. doi:10.4240/wjgs.v9.i1.1. PMC 5237817. PMID 28138363.
- ↑ Bertleff MJ, Lange JF (2010). "Perforated peptic ulcer disease: a review of history and treatment". Dig Surg. 27 (3): 161–9. doi:10.1159/000264653. PMID 20571260.
- ↑ CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
- ↑ CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=10313974
- ↑ Bertleff MJ, Lange JF (2010). "Perforated peptic ulcer disease: a review of history and treatment". Dig Surg. 27 (3): 161–9. doi:10.1159/000264653. PMID 20571260.
- ↑ Chung KT, Shelat VG (2017). "Perforated peptic ulcer - an update". World J Gastrointest Surg. 9 (1): 1–12. doi:10.4240/wjgs.v9.i1.1. PMC 5237817. PMID 28138363.