Peptic Ulcer Disease – Part 4
There are several tests used to diagnose peptic ulcer disease and to differentiate this condition from other causes. Typically the first imaging test a patient with a complaint of epigastric (the area on the abdominal wall just below the sternum) or right upper quadrant pain receives is an ultrasound of the upper abdomen. This is a quick, cheap, noninvasive test that will pick up the signs of cholecystitis (inflammation of the gallbladder). These signs include cholelithiasis (presence of gallstones in the gallbladder), gallbladder sludge (self-explanatory), pericholecystic fluid (fluid around the gallbladder), gallbladder wall thickening, choledocholithiasis (gallstones in the common bile duct), and dilated common and hepatic bile ducts.
If the ultrasound is negative, the next test usually obtained is a computed tomography (CT scan) with intravenous and oral contrast. This test is good at picking up intraabdominal masses that might be causing pain but is not particularly good at picking up ulcer disease.
If the ultrasound and CT scan are negative, the patient is usually offered esophagogastroduodenoscopy (EGD). This is both more sensitive and specific than contrast examination (Upper GI test) and provides for direct visualization of the stomach and duodenum through placement of a lighted, flexible scope through the mouth and into the stomach. During EGD tissue biopsies are always obtained to check for the presence of H. pylori and to rule out the presence of malignancy in gastric ulcers.
Prior to starting your first entry for a new letter just paste
Copyright 2007 InsideSurgery.com