(PPT) A case presentation on peptic ulcers | Teja Mudhinella - andaluciapodemos.info
In summary, this is a year old hypertensive woman who presented with left-sided abdominal pain and diarrhea, and was found to have multiple gastric and duodenal ulcers. The patient improved on proton-pump inhibitors, but withdrawal of proton-pump inhibitors led to a recurrence of symptoms, and recurrent duodenal ulcers. There were no significant findings on physical examination, and a serum gastrin level taken initially was normal. Radiological studies were remarkable for diffusely thickened gastric folds in the face of a distended stomach, and a hypervascular 1cm nodule within the liver. Both of these radiologic findings have specific differential diagnoses. Thickened gastric folds are associated with malignancy usually lymphoma, but poorly-differentiated signet ring cell gastric carcinoma is also a possibility , Menetrier's disease, Zollinger-Ellison syndrome and gastritis. Hypervascular nodules within the liver are found with primary liver disorders hepatocellular carcinoma, hemangioma or focal nodular hyperplasia , or metastatic lesions to the liver typically highly vascular tumors such as renal cell carcinoma, carcinoid tumor, melanoma, islet cell tumor, choriocarcinoma, or breast carcinoma.
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