Peptic ulcer differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differentiating Peptic Ulcer from other Diseases
- Acute upper gastrointestinal bleeding: PUD accounts for the majority of acute episodes of gastrointestinal bleeding[1] (up to 40%)[2], but there are other causes:[3]
- Esophageal varices: history of cirrhosis (and portal hypertension)
- Mallory-Weiss syndrome: history of repeated vomiting
- Gastrointestinal cancer: history of anorexia or weight loss, tobacco smoking and alcohol drinking.
- Arteriovenous malformations: Painless bleeding in >70 years old patients, history of iron deficiency anemia.
- Esophagitis or esophageal ulcer: heartburn, indigestion, or dysphagia
- Dieulafoy ulcer: painless bleeding
- Alpha-1 Antitrypsin Deficiency AATD: besides lung disease, liver disease (hepatitis, cirrhosis, and hepatoma) represents another clinical manifestation of AATD,[4][5] therefore those patients can present upper gastrointestinal bleeding and abdominal pain, in the context of altered liver function.[6]
- Cirrhosis
- Gastroesophageal reflux disease (GERD)
- Hyperparathyroidism
- Irritable bowel syndrome
- Pancreatitis
- Zollinger-Ellison Syndrome
References
- ↑ Gralnek IM, Barkun AN, Bardou M (2008). "Management of acute bleeding from a peptic ulcer". N Engl J Med. 359 (9): 928–37. doi:10.1056/NEJMra0706113. PMID 18753649.
- ↑ Dallal HJ, Palmer KR (2001). "ABC of the upper gastrointestinal tract: Upper gastrointestinal haemorrhage". BMJ. 323 (7321): 1115–7. PMC 1121602. PMID 11701581.
- ↑ Wilkins T, Khan N, Nabh A, Schade RR (2012). "Diagnosis and management of upper gastrointestinal bleeding". Am Fam Physician. 85 (5): 469–76. PMID 22534226.
- ↑ Stoller JK, Aboussouan LS (2012). "A review of α1-antitrypsin deficiency". Am J Respir Crit Care Med. 185 (3): 246–59. doi:10.1164/rccm.201108-1428CI. PMID [ 21960536 [ Check
|pmid=value (help). - ↑ Silverman EK, Sandhaus RA (2009). "Clinical practice. Alpha1-antitrypsin deficiency". N Engl J Med. 360 (26): 2749–57. doi:10.1056/NEJMcp0900449. PMID 19553648.
- ↑ Nelson DR, Teckman J, Di Bisceglie AM, Brenner DA (2012). "Diagnosis and management of patients with α1-antitrypsin (A1AT) deficiency". Clin Gastroenterol Hepatol. 10 (6): 575–80. doi:10.1016/j.cgh.2011.12.028. PMC 3360829. PMID 22200689.