Case 2 - clinical aspects of gastric and duodenal disorders Flashcards
what are some upper GI symptoms
indigestion
heartburn
reflux
bloating or distention
vomiting
haematemesis
malaena
weight loss
early satiety
anorexia
what are some of the signs of cancer
early satiety (feeling full very quickly)
anorexia
vomiting
weight loss
what is melaena
passage of black, tar stool - loose motions and offensive swelling (gastrointestinal bleedIing)
what is obesity a sign of
cancer of the gastro-oesophageal junction
what is cachexia
wright loss
what is succussion splash
patients who have an obstruction - blockage to the outlet of the stomach
what is Virchow’s node
node in the left supraclavicular fossa - Troisier sign - cancer
what is umbilical nodule a sign of
gastric cancer
what are the tests run if there are no cancer red flags
Helicobacter pylori-stool antigen, urea breath test, gastric biopsy
Barium studies (establish if there are any obstructions) / USS
OGD
pH and manometry
BRAVO capsule
what are the tests run if there is a suspicion of malignant pathology
blood tests - FBC, UEs, LFTs, Iron studies
OGD
CT scan
PET-CT scan
Laparoscopy
what are examples of benign disease
gastritis
Peptic ulceration
GORD
Achalasia
Functional disorders
Crohn’s disease
what are the tests used for H pylori stool
stool antigen test - PPI will interfere with result
13 urea breath test - PPI will interfere with result
Serology - cannot distinguish active from previous infection
CLO test - biopsy during gastroscopy
what are complications of peptic ulceration
pain
Heartburn
Reflux
Bleeding - due to gastroduodenal artery or supraduodenal artery
Perforation
Stricture / obstruction
Malignancy
can the duodenum perforate due to a stomach ulceration
yes
what is the genetic mutation in malignancy of the stomach
Hereditary diffuse gastric cancer (HDGC) CDH1
