3.1 DU General Considerations· DUs are most common in the young and middle-aged (20-45 years)..Men>women.·About95%DUsaresituatedwithin2cmofthepylorus,intheduodenal bulb
3.1 DU_General Considerations • DUs are most common in the young and middle-aged (20-45 years). • Men ＞ women. • About 95% DUs are situated within 2 cm of the pylorus, in the duodenal bulb
3.1 DU Clinical FindingsA. Symptoms and Signs·Pain,presenting in most patients,located inthe epigastrium and isvariably described as aching,burning,orgnawing..Daily cycle of the pain.no pain in the morning until an hour or moreafterbreakfast.The pain is relieved by the noon meal, only to recur in thelaterafternoon. Pain may appear again in the evening, and in about half of cases itarouses the patient during the night.Food, milk, or antacid preparations givetemporaryrelief..Varying degrees of nausea and vomiting are common
3.1 DU_Clinical Findings A. Symptoms and Signs • Pain, presenting in most patients, located in the epigastrium and is variably described as aching, burning, or gnawing. • Daily cycle of the pain. no pain in the morning until an hour or more after breakfast. The pain is relieved by the noon meal, only to recur in the later afternoon. Pain may appear again in the evening, and in about half of cases it arouses the patient during the night. Food, milk, or antacid preparations give temporary relief. • Varying degrees of nausea and vomiting are common
3.1 DU Clinical FindingsB. Endoscopy·Gastroduodenoscopyisuseful in evaluating patientswith an uncertain diagnosis,those with bleeding fromthe upper intestine, andthose who have obstructionof the gastroduodenalsegment and for assessingresponsetotherapy
3.1 DU_Clinical Findings B. Endoscopy • Gastroduodenoscopy is useful in evaluating patients with an uncertain diagnosis, those with bleeding from the upper intestine, and those who have obstruction of the gastroduodenal segment and for assessing response to therapy
3.1 DU Clinical FindingsC.Diagnostic TestsMean values foracid outputduringgastric analysisfor normals andpatients withduodenalulcer.Theupper limits of normalare:Basal,5 1. Gastric analysis:meq/h;maximal,30meq/h.(1)basal acid outputMeanAcidOutput (meg/h)Gender(BAO).DUNormal.(2)maximalacidoutput2.5Male5.5Basal(MAO).1.53.0Female2.Serumgastrin30Male40Maximal(pentagastrin)2030Female·3.RadiographicStudies
3.1 DU_Clinical Findings C. Diagnostic Tests • 1. Gastric analysis: • (1) basal acid output (BAO). • (2) maximal acid output (MAO). • 2.Serum gastrin • 3.Radiographic Studies Mean values for acid output during gastric analysis for normals and patients with duodenal ulcer. The upper limits of normal are: Basal, 5 meq/h; maximal, 30 meq/h. Gender Mean Acid Output (meq/h) Normal DU Basal Male 2.5 5.5 Female 1.5 3.0 Maximal (pentagastrin) Male 30 40 Female 20 30
3.1 DU Clinical FindingsD.Radiographic Studies
3.1 DU_Clinical Findings D. Radiographic Studies