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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

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

HEENT

Lungs

Heart

  • S1 and S2 normal ,no murmur/rubs/gallops.

Abdomen

References

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  1. 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.
  2. 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.
  3. CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
  4. CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=10313974
  5. 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.
  6. 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.

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