Peptic ulcer X ray: Difference between revisions
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{{Peptic ulcer}}{{CMG}} | __NOTOC__ | ||
{{Peptic ulcer}} | |||
{{CMG}} ; {{AE}} {{MKK}} | |||
==Overview== | ==Overview== | ||
If a peptic ulcer perforates, air will leak from the inside of the gastrointestinal tract (which always contains some air) to the peritoneal cavity (which normally never contains air). This leads to "free gas" within the peritoneal cavity. If the patient stands erect, as when having a chest X-ray, the gas will float to a position underneath the diaphragm. Therefore, gas in the peritoneal cavity, shown on an erect chest X-ray or supine lateral abdominal X-ray, is an omen of perforated peptic ulcer disease. | If a [[peptic ulcer]] perforates, air will leak from the inside of the gastrointestinal tract (which always contains some air) to the peritoneal cavity (which normally never contains air). This leads to "free gas" within the peritoneal cavity. If the patient stands erect, as when having a [[chest X-ray]], the gas will float to a position underneath the [[diaphragm]]. Therefore, gas in the [[peritoneal cavity]], shown on an erect [[chest X-ray]] or supine lateral [[abdominal X-ray]], is an omen of perforated [[peptic ulcer disease]]. | ||
==X Ray== | |||
There are no [[abdominal x-ray]] findings associated with [[peptic ulcer disease]]. However, an [[x-ray]] may be helpful in the diagnosing the complications of underlying disease. Findings of [[abdominal X-ray]] in perforated peptic ulcer include free air under the diaphragm called as [[pneumoperitoneum]].<ref name="pmid26460663"><nowiki>{{cite journal |vauthors=Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA |title=Perforated peptic ulcer |journal=Lancet |volume=386 |issue=10000 |pages=1288–1298 |year=2015 |pmid=26460663 |pmc=4618390 |doi=10.1016/S0140-6736(15)00276-7 |url</nowiki></ref><ref name="pmid21567292">{{cite journal |vauthors=Thorsen K, Glomsaker TB, von Meer A, Søreide K, Søreide JA |title=Trends in diagnosis and surgical management of patients with perforated peptic ulcer |journal=J. Gastrointest. Surg. |volume=15 |issue=8 |pages=1329–35 |year=2011 |pmid=21567292 |pmc=3145078 |doi=10.1007/s11605-011-1482-1 |url=}}</ref> | |||
[[File:Pneumoperitoneum-12.jpg|200px|thumb|centre|Pneumoperitoneum''Source:Case courtesy of A.Prof Frank Gaillard<ref>="https://radiopaedia.org/">Radiopaedia.org</ref><ref>="https://radiopaedia.org/cases/17957">rID: 17957</ref>]] | |||
==Barium swallow== | |||
The [[barium swallow]] is also used to diagnose [[peptic ulcer]] and to differentiate between [[benign]] and [[malignant ulcer]].<ref name="pmid19999206">{{cite journal |vauthors=Nawaz M, Jehanzaib M, Khan K, Zari M |title=Role of barium meal examination in diagnosis of peptic ulcer |journal=J Ayub Med Coll Abbottabad |volume=20 |issue=4 |pages=59–61 |year=2008 |pmid=19999206 |doi= |url=}}</ref> | |||
===Distinguishing features between benign and malignant ulcer=== | |||
Barium swallow helps to distinguish between benign and malignant ulcer | |||
{| class="wikitable" | |||
! colspan="2" |Barium swallow findings | |||
|- | |||
!Benign ulcer | |||
!Malignant ulcer | |||
|- | |||
|Smooth rounded and deep ulcer crater | |||
|Irregular and shallow ulcer crater | |||
|- | |||
|Smooth ulcer mound | |||
|Nodular and angular ulcer mound | |||
|- | |||
|Smooth folds that reach the '''margin''' of the ulcer | |||
|Nodular gastric folds that '''do not reach''' the ulcer margin | |||
|- | |||
|Hampton's line<ref name="pmid19999206">{{cite journal |vauthors=Nawaz M, Jehanzaib M, Khan K, Zari M |title=Role of barium meal examination in diagnosis of peptic ulcer|journal=J Ayub Med Coll Abbottabad |volume=20 |issue=4 |pages=59–61 |year=2008 |pmid=19999206 |doi= |url=}}</ref> | |||
|Carman meniscus sign | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
Latest revision as of 23:38, 29 July 2020
Peptic ulcer Microchapters |
Diagnosis |
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Treatment |
Surgery |
Case Studies |
2017 ACG Guidelines for Peptic Ulcer Disease |
Guidelines for the Indications to Test for, and to Treat, H. pylori Infection |
Guidlines for factors that predict the successful eradication when treating H. pylori infection |
Guidelines to document H. pylori antimicrobial resistance in the North America |
Guidelines for evaluation and testing of H. pylori antibiotic resistance |
Guidelines for when to test for treatment success after H. pylori eradication therapy |
Guidelines for penicillin allergy in patients with H. pylori infection |
Peptic ulcer X ray On the Web |
American Roentgen Ray Society Images of Peptic ulcer X ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
If a peptic ulcer perforates, air will leak from the inside of the gastrointestinal tract (which always contains some air) to the peritoneal cavity (which normally never contains air). This leads to "free gas" within the peritoneal cavity. If the patient stands erect, as when having a chest X-ray, the gas will float to a position underneath the diaphragm. Therefore, gas in the peritoneal cavity, shown on an erect chest X-ray or supine lateral abdominal X-ray, is an omen of perforated peptic ulcer disease.
X Ray
There are no abdominal x-ray findings associated with peptic ulcer disease. However, an x-ray may be helpful in the diagnosing the complications of underlying disease. Findings of abdominal X-ray in perforated peptic ulcer include free air under the diaphragm called as pneumoperitoneum.[1][2]
Barium swallow
The barium swallow is also used to diagnose peptic ulcer and to differentiate between benign and malignant ulcer.[5]
Distinguishing features between benign and malignant ulcer
Barium swallow helps to distinguish between benign and malignant ulcer
Barium swallow findings | |
---|---|
Benign ulcer | Malignant ulcer |
Smooth rounded and deep ulcer crater | Irregular and shallow ulcer crater |
Smooth ulcer mound | Nodular and angular ulcer mound |
Smooth folds that reach the margin of the ulcer | Nodular gastric folds that do not reach the ulcer margin |
Hampton's line[5] | Carman meniscus sign |
References
- ↑ {{cite journal |vauthors=Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA |title=Perforated peptic ulcer |journal=Lancet |volume=386 |issue=10000 |pages=1288–1298 |year=2015 |pmid=26460663 |pmc=4618390 |doi=10.1016/S0140-6736(15)00276-7 |url
- ↑ Thorsen K, Glomsaker TB, von Meer A, Søreide K, Søreide JA (2011). "Trends in diagnosis and surgical management of patients with perforated peptic ulcer". J. Gastrointest. Surg. 15 (8): 1329–35. doi:10.1007/s11605-011-1482-1. PMC 3145078. PMID 21567292.
- ↑ ="https://radiopaedia.org/">Radiopaedia.org
- ↑ ="https://radiopaedia.org/cases/17957">rID: 17957
- ↑ 5.0 5.1 Nawaz M, Jehanzaib M, Khan K, Zari M (2008). "Role of barium meal examination in diagnosis of peptic ulcer". J Ayub Med Coll Abbottabad. 20 (4): 59–61. PMID 19999206.