|
|
| Line 41: |
Line 41: |
| * [[Zollinger-Ellison Syndrome]] | | * [[Zollinger-Ellison Syndrome]] |
|
| |
|
| <small>
| | |
| {| class="wikitable" | | {| style="border: 0px; font-size: 80%; margin: 3px;" align="center" |
| | | colspan="13" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|'''Differential Diagnosis'''}} |
| | |+ |
| | rowspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Disease'''}} | | | rowspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Disease'''}} |
| | rowspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Cause'''}} | | | rowspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Cause'''}} |
| Line 136: |
Line 138: |
| | | | | |
| * [[Iron deficiency anemia]] | | * [[Iron deficiency anemia]] |
| Autoimmune gastritis diagnosis include: | | *Autoimmune gastritis diagnosis includes: |
| * Antiparietal and anti-IF antibodies | | **Antiparietal and anti-IF antibodies |
| * [[Achlorhydria]] and hypergastrinemia | | **[[Achlorhydria]] and hypergastrinemia |
| * Low serum [[vitamin B12|cobalamine]] | | **Low serum [[vitamin B12|cobalamine]] |
| |- | | |- |
| | style="padding: 5px 5px; background: #DCDCDC;" |[[Crohn's disease]] | | | style="padding: 5px 5px; background: #DCDCDC;" |[[Crohn's disease]] |
| Line 317: |
Line 319: |
| |} | | |} |
|
| |
|
| ==Differential Diagnosis==
| |
| Gastritis must be differentiated from:<ref name="pmid6710074">{{cite journal| author=Sugimachi K, Inokuchi K, Kuwano H, Ooiwa T| title=Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy. | journal=Scand J Gastroenterol | year= 1984 | volume= 19 | issue= 1 | pages= 31-7 | pmid=6710074 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6710074 }} </ref><ref name="pmid25901896">{{cite journal| author=Sipponen P, Maaroos HI| title=Chronic gastritis. | journal=Scand J Gastroenterol | year= 2015 | volume= 50 | issue= 6 | pages= 657-67 | pmid=25901896 | doi=10.3109/00365521.2015.1019918 | pmc=4673514 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25901896 }} </ref><ref name="pmid16819502">{{cite journal| author=Sartor RB| title=Mechanisms of disease: pathogenesis of Crohn's disease and ulcerative colitis. | journal=Nat Clin Pract Gastroenterol Hepatol | year= 2006 | volume= 3 | issue= 7 | pages= 390-407 | pmid=16819502 | doi=10.1038/ncpgasthep0528 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16819502 }} </ref><ref name="pmid2789799">{{cite journal| author=Sipponen P| title=Atrophic gastritis as a premalignant condition. | journal=Ann Med | year= 1989 | volume= 21 | issue= 4 | pages= 287-90 | pmid=2789799 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2789799 }} </ref><ref name="pmid25133039">{{cite journal| author=Badillo R, Francis D| title=Diagnosis and treatment of gastroesophageal reflux disease. | journal=World J Gastrointest Pharmacol Ther | year= 2014 | volume= 5 | issue= 3 | pages= 105-12 | pmid=25133039 | doi=10.4292/wjgpt.v5.i3.105 | pmc=4133436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25133039 }} </ref><ref name="pmid17956071">{{cite journal| author=Ramakrishnan K, Salinas RC| title=Peptic ulcer disease. | journal=Am Fam Physician | year= 2007 | volume= 76 | issue= 7 | pages= 1005-12 | pmid=17956071 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17956071 }} </ref><ref name="pmid17985090">{{cite journal| author=Banasch M, Schmitz F| title=Diagnosis and treatment of gastrinoma in the era of proton pump inhibitors. | journal=Wien Klin Wochenschr | year= 2007 | volume= 119 | issue= 19-20 | pages= 573-8 | pmid=17985090 | doi=10.1007/s00508-007-0884-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17985090 }} </ref><ref name="pmid15621988">{{cite journal| author=Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM| title=Gastric adenocarcinoma: review and considerations for future directions. | journal=Ann Surg | year= 2005 | volume= 241 | issue= 1 | pages= 27-39 | pmid=15621988 | doi= | pmc=1356843 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15621988 }} </ref><ref name="pmid21390139">{{cite journal| author=Ghimire P, Wu GY, Zhu L| title=Primary gastrointestinal lymphoma. | journal=World J Gastroenterol | year= 2011 | volume= 17 | issue= 6 | pages= 697-707 | pmid=21390139 | doi=10.3748/wjg.v17.i6.697 | pmc=3042647 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21390139 }} </ref>
| |
| <div style="width: 85%;">
| |
|
| |
|
| {| class="wikitable"
| |
| ! rowspan="3" |Disease
| |
| ! rowspan="3" |Cause
| |
| ! colspan="9" |Symptoms
| |
| !Diagnosis
| |
| ! rowspan="3" |Other findings
| |
| |-
| |
| ! colspan="3" |Pain
| |
| ! rowspan="2" |Nausea
| |
| &
| |
|
| |
|
| Vomiting
| |
| ! rowspan="2" |Heartburn
| |
| ! rowspan="2" |Belching or
| |
| Bloating
| |
| ! rowspan="2" |Weight loss
| |
| ! rowspan="2" |Loss of
| |
| Appetite
| |
| ! rowspan="2" |Stools
| |
| ! rowspan="2" |Endoscopy findings
| |
| |-
| |
| !Location
| |
| !Aggravating Factors
| |
| !Alleviating Factors
| |
| |-
| |
| ![[Acute gastritis]]
| |
| |
| |
| * ''[[H. pylori]]''
| |
| * [[NSAIDS]]
| |
| * [[Corticosteroids]]
| |
| * [[Alcohol]]
| |
| * Spicy food
| |
| * Viral infections
| |
| * [[Crohn's disease]]
| |
| * [[Autoimmune diseases]]
| |
| * Bile reflux
| |
| * [[Cocaine]] use
| |
| * Breathing machine or ventilator
| |
| * Ingestion of [[corrosive|corrosives]]
| |
| |
| |
| * [[Epigastric pain]]
| |
| |Food
| |
| |[[Antacids]]
| |
| |?
| |
| |?
| |
| |?
| |
| |<nowiki>-</nowiki>
| |
| |?
| |
| |[[Melena|Black stools]]
| |
| |
| |
| * Pangastritis or antral [[gastritis]]
| |
| * [[Gastric erosion|Erosive]] (Superficial, deep, hemorrhagic)
| |
| * Nonerosive (''[[H. pylori]]'')
| |
| |<nowiki>-</nowiki>
| |
| |-
| |
| ![[Gastritis|Chronic gastritis]]
| |
| |
| |
| * ''[[H. pylori]]''
| |
| * [[Alcohol]]
| |
| * Medications
| |
| * [[Autoimmune diseases]]
| |
| * Chronic stress
| |
| |
| |
| * [[Epigastric pain]]
| |
| |Food
| |
| |[[Antacids]]
| |
| |?
| |
| |?
| |
| |?
| |
| |?
| |
| |?
| |
| |<nowiki>-</nowiki>
| |
| |''[[H. pylori]] [[gastritis]]''
| |
| * [[Atrophy]]
| |
| * Intestinal [[metaplasia]]
| |
| Lymphocytic gastritis
| |
| * Enlarged folds
| |
| * Aphthoid erosions
| |
| |<nowiki>-</nowiki>
| |
| |-
| |
| ![[Atrophic gastritis]]
| |
| |
| |
| * ''[[H. pylori]]''
| |
| * [[Autoimmune disease]]
| |
| |[[Epigastric pain]]
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |?
| |
| |<nowiki>-</nowiki>
| |
| |
| |
| |?
| |
| |?
| |
| |<nowiki>-</nowiki>
| |
| |''[[H. pylori]]''
| |
| * Mucosal [[atrophy]]
| |
| [[Autoimmune]]
| |
| * Mucosal [[atrophy]]
| |
| |
| |
| * [[Iron deficiency anemia]]
| |
| Autoimmune gastritis diagnosis include:
| |
| * Antiparietal and anti-IF antibodies
| |
| * [[Achlorhydria]] and hypergastrinemia
| |
| * Low serum [[vitamin B12|cobalamine]]
| |
| |-
| |
| ![[Crohn's disease]]
| |
| |
| |
| * [[Autoimmune disease]]
| |
| |
| |
| * [[Abdominal pain]]
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |?
| |
| |?
| |
| |
| |
| * Chronic [[diarrhea]] often bloody with [[pus]] or [[mucus]]
| |
| * [[Rectal bleeding]]
| |
| |
| |
| * Mucosal nodularity with cobblestoning
| |
| * Multiple [[aphthous ulcers]]
| |
| * Linier or serpiginous ulcerations
| |
| * Thickened antral folds
| |
| * Antral narrowing
| |
| * Hypoperistalsis
| |
| * Duodenal strictures
| |
| |
| |
| * [[Fever]]
| |
| * [[Fatigue]]
| |
| * [[Anemia]] ([[pernicious anemia]])
| |
| |-
| |
| ![[GERD]]
| |
| |
| |
| * Lower esophageal sphincter abnormalities
| |
|
| |
|
| * [[Hiatal hernia]]
| |
| * Abnormal esophageal contractions
| |
| * Prolonged emptying of [[stomach]]
| |
| * [[Gastrinomas]]
| |
| |
| |
| * [[Epigastric pain]]
| |
| |
| |
| * Spicy food
| |
| * Tight fitting clothing
| |
| |
| |
| * [[Antacids]]
| |
| * Head elevation during sleep
| |
| |?
| |
|
| |
|
| (Suspect delayed gastric emptying)
| |
| |?
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |
| |
| * [[Esophagitis]]
| |
| * Barrette esophagus
| |
| * [[Strictures]]
| |
| |Other symptoms:
| |
| * [[Dysphagia]]
| |
| * [[Regurgitation]]
| |
| * [[Cough|Nocturnal cough]]
| |
| * [[Hoarseness]]
| |
| Complications
| |
| * [[Esophagitis]]
| |
| * [[Strictures]]
| |
| * Barrette esophagus
| |
| |-
| |
| ![[Peptic ulcer disease]]
| |
| |
| |
| * ''[[H. pylori]]''
| |
| * [[Smoking]]
| |
| * [[Alcohol]]
| |
| * [[Radiation therapy]]
| |
| * Medications
| |
| * Zollinger-ellison syndrome
| |
| |
| |
| * [[Epigastric pain]] sometimes extending to back
| |
| * [[Right upper quadrant pain]]
| |
| |
| |
| '''[[Duodenal ulcer]]'''
| |
| *Pain aggravates with empty stomach
| |
| '''[[Gastric ulcer]]'''
| |
| *Pain aggravates with food
| |
| |
| |
| * [[Antacids]]
| |
|
| |
|
| * [[Duodenal ulcer]]
| |
| :*Pain alleviates with food
| |
| |?
| |
| |?
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |
| |
| * [[Melena|Black stools]]
| |
| |'''Gastric ulcers'''
| |
| * Discrete mucosal lesions with a punched-out smooth ulcer base with whitish fibrinoid base
| |
| * Most [[ulcers]] are at the junction of [[fundus]] and antrum
| |
| * 0.5-2.5cm
| |
| '''Duodenal ulcers'''
| |
| * Well-demarcated break in the [[mucosa]] that may extend into the [[muscularis propria]] of the [[duodenum]]
| |
| * Found in the first part of [[duodenum]]
| |
| * <1cm
| |
| |'''Other diagnostic tests'''
| |
| * Serum [[gastrin]] levels
| |
| * [[Secretin]] stimulation test
| |
| * [[Biopsy]]
| |
| |-
| |
| ![[Gastrinoma]]
| |
| |
| |
| * Associated with [[MEN type 1]]
| |
| |
| |
| * [[Abdominal pain]]
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |?
| |
|
| |
|
| (suspect [[gastric outlet obstruction]])
| | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" |
| |?
| | | colspan="3" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|'''Aravind'''}} |
| |<nowiki>-</nowiki> | | |+ |
| |<nowiki>-</nowiki> | | | style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Reddy'''}} |
| |<nowiki>-</nowiki>
| | | style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Reddy'''}} |
| |
| | | style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Reddy'''}} |
| * [[Melena|Black stools]]
| | | style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Reddy'''}} |
| |Useful in collecting the tissue for [[biopsy]] | |
| | | |
| * May present with symptoms of [[GERD]] or [[peptic ulcer disease]]
| |
| * Associated with [[MEN type 1]]
| |
| '''Diagnostic tests''' | |
| * Serum [[gastrin]] levels
| |
| * [[Somatostatin]] receptor [[scintigraphy]]
| |
| * [[CT]] and [[MRI]]
| |
| |- | |
| ![[Gastric Cancer|Gastric Adenocarcinoma]]
| |
| | | |
| * ''[[H. pylori]]'' infection
| |
| * Smoked and salted food
| |
| | | |
| * [[Abdominal pain]]
| |
| |<nowiki>-</nowiki> | |
| |<nowiki>-</nowiki> | |
| |? | |
| |?
| |
| |?
| |
| |? | |
| |? | |
| | | |
| * [[Melena|Black stools]], or blood in stools
| |
| |'''Esophagogastroduodenoscopy''' | |
| * Multiple biopsies are taken to establish the diagnosis
| |
| |'''Other symptoms''' | |
| * [[Dysphagia]]
| |
| * Early [[satiety]]
| |
| * Frequent [[burping]]
| |
| |- | | |- |
| ![[Gastric lymphoma|Primary gastric lymphoma]]
| |
| |
| |
| * ''[[H. pylori]]'' infection
| |
| |
| |
| * [[Abdominal pain]]
| |
| * [[Chest pain]]
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |?
| |
| |<nowiki>-</nowiki>
| |
| |<nowiki>-</nowiki>
| |
| |Useful in collecting the tissue for [[biopsy]]
| |
| |'''Other symptoms'''
| |
| * Painless swollen [[lymph nodes]] in neck and armpit
| |
| * Night sweats
| |
| * [[Fatigue]]
| |
| * [[Fever]]
| |
| * [[Cough]] or trouble breathing
| |
| |} | | |} |
|
| |
| </div>
| |
|
| |
|
| |
|
| ==References== | | ==References== |