PATHOPHYSIOLOGY OF ACUTE PEPTIC ULCER DISEASE

Risk Factors
1. Age: 5 !ears o"# a$# a%o&e
'. Stress
(. Ha&i$g a$ O %"oo# t!)e
*. He"ico%acter )!"ori i$+ectio$
5. I$gestio$ o+ gastric irrita$ts:
,A"co-o". /i"k. ca++ei$e. so0r +oo#1
2. Ha&i$g ot-er i""$esses
,Patie$t -as e3isti$g re$a" a$#
-e)atic #isor#ers1
I$crease#
gastri$ secretio$
I$crease# gastric
aci# )ro#0ctio$
Da/age4erosio$ o+
t-e /0cosa
1. So0r er0ctatio$
'. Hicc0))i$g
For/atio$
o+ 0"cers
1. E)igastric )ai$
'. 5o/iti$g
(. Loss4#ecrease#
a))etite
Gastroi$testi$a" %"ee#i$g
Sig$s a$# s!/)to/s o+
A$e/ia
1. 5ita" sig$s c-a$ges:
6 Tac-!car#ia
6 Tac-!)$ea
6 Lo7 %"oo# )ress0re
'. Fai$t$ess4#i88i$ess
(. Se&ere )a""or
*. Pa"e co$90$cti&a
5. Pa"e $ai"%e#s
2. Eas! +atiga%i"it!
:. Decrease# -e/atocrit
;. Decrease# -e/og"o%i$
Stoo" c-a$ge,s1:
<e"e$a
Decrease#
resista$ce to
%acteria
I$crease#
He"ico%acter
)!"ori
)ro"i+eratio$
I$+"a//atio$
o+ t-e gastric
/0cosa
ACUTE PEPTIC ULCER DISEASE
=ITH I>TER5E>TIO>S
<e#ica" <a$age/e$t:
1. A$taci#s a$# Proto$6)0/) i$-i%itors
'. A$ti+i%ri$o"!tics
(. A$ti6i$+ecti&es: H. )!"ori era#icatio$ t-era)!
*. Prostag"a$#i$ E1 A$a"og0e
>0rsi$g <a$age/e$t:
1. Pai$ re"ie+
'. <a$age/e$t o+ %"ee#i$g
(. <o$itori$g a$# /a$age/e$t o+ )ote$tia"
co/)"icatio$s
*. Hea"t- e#0catio$ RECO5ERY: GOOD PROG>OSIS
=ITHOUT I>TER5E>TIO>S
?"ee#i$g co$ti$0es
Decrease i$
circ0"ati$g
%"oo# &o"0/e
H!)o&o"e/ic s-ock
,I$a#e@0ate %rai$ tiss0e )er+0sio$1
DEATH: ?AD PROG>OSIS