Peptic Ulcer Dse Pathophysiology

download Peptic Ulcer Dse Pathophysiology

of 19

Transcript of Peptic Ulcer Dse Pathophysiology

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    1/19

    PEPTIC ULCER

    DISEASE(revised)

    RN

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    2/19

    Peptic Ulcer DiseaseULCER craterlike lesion in a membrane

    Ulcers tat develop in areas o! te "IT e#posed to acidic$astric %&ice are called PEPTIC ULCERS

    Erosions vs Tr&e Ulcers

    PUD ' can develop in te loer esopa$&s stomacd&oden&m or %e%&n&m

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    3/19

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    4/19

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    5/19

    T*+ ,A-+R .+R,SD&odenal Ulcer a/ect te &pper part o! te small intestines

    acco&nts 012 o! PUD

    "astric Ulcer

    a/ects stomac linin$ common in middle'a$ed 3 elderl4esp5 poor 3

    malno&rised

    common in cronic &sers o! ASA 3 R+6

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    6/19

    Etiolo$4 7 U898+*8

    ,A-+R C+8TRI:UT+RS

    Camp4lobacter p4lori

    Ureasesplits te &rea into ammonia andC+;

    Catalase

    Adesion proteins

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    7/19

    ,A-+R C+8TRI:UT+RS

    8on'steroidal anti'in&ac4 ma4 alsocontrib&te

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    8/19

    Contrib&tin$ !actors

    Personal type A & Blood Type O

    Genetic predisposition

    Tobacco use

    Ingestion of food or drugs

    tress

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    9/19

    PATHOPHYSIOLOGY

    ULCERATION

    ^ HCl ACID

    PRODUCTION

    :ILE SALTS ASPIRI8 ALC+6+LISC6E,IA

    DA,A"ED ,UC+SAL :ARRIER

    DEC5 .?8 +. ,UC+SAL CELLSDEC5 @UALIT +. ,UCUS

    L+SS +. TI"6T -U8CTI+8S :ET5 CELLS

    PEPSINOGEN

    PEPSIN

    FORMATION AND

    LIBERATION OF

    HISTAMINE

    :AC9'DI..USI+8 +. ACID I8T+ "ASTRIC,UC+SA

    FURTHER MUCOSALEROSION

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    10/19

    ULCERATION OF MUCOSA

    (GASTRIC / DUODENAL)

    !burning, gna"ing, orcrampli#e pain!epigastrictenderness

    !$oluntary muscleguarding

    NO TXMENT?

    CONTINUOUS EROSION OF

    MUCOSA

    A B C

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    11/19

    Erosion o !"#

    $l%#r in!o &n&r!#r' or #in

    P#ror&!ion o !"#

    $%os&l *&ll

    G&s!roin!#s!in&l

    +l##,in-

    s/sx:

    hemate

    mesis

    melena

    anemia

    S.ill&-# G&s!ri%

    #n'#s &n, +ol$s

    in!o &+,oin&l %&i!'

    A B

    S%&rrin- &n, s*#llin- o

    !"# $%os&

    N&rro*in- in !"#

    ,$o,#n$ &n,/or

    n#&r .'lori% %&n&l

    C

    P#ri!oni!is &n, .&n%r#&!i!is

    M&ssi# +loo,

    loss

    s"o%0

    S#.sis

    S#.!i% s"o%0

    DEATH

    G&s!ri% o$!l#!o+s!r$%!ion

    Dis!#n!ion &n, !iss$#

    ,&&-#

    B

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    12/19

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    13/19

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    14/19

    http://images.search.yahoo.com/search/images/view?back=http%3A%2F%2Fimages.search.yahoo.com%2Fsearch%2Fimages%3Fp%3Dhelicobacter%2Bpylori%26ei%3DUTF-8%26fr%3Dyfp-t-331%26fp_ip%3DPH%26x%3Dwrt%26js%3D1%26ni%3D20&w=300&h=225&imgurl=www.gastroenterologe.de%2F_gfx%2Fhel_pylori.jpg&rurl=http%3A%2F%2Fwww.gastroenterologe.de%2Fpatient%2Ferkrankungen%2Fmagen%2Fhelicobacter_inf.html&size=4.7kB&name=hel_pylori.jpg&p=helicobacter+pylori&type=jpeg&no=13&tt=8,141&oid=c1f0749f6ff76924&ei=UTF-8http://images.search.yahoo.com/search/images/view?back=http%3A%2F%2Fimages.search.yahoo.com%2Fsearch%2Fimages%3Fp%3Dhelicobacter%2Bpylori%26ei%3DUTF-8%26fr%3Dyfp-t-331%26fp_ip%3DPH%26x%3Dwrt%26js%3D1%26ni%3D20&w=148&h=214&imgurl=water.usgs.gov%2Fnrp%2Fproj.bib%2Fmicrobiology%2FHelicobacter_pylori.jpg&rurl=http%3A%2F%2Fwater.usgs.gov%2Fnrp%2Fproj.bib%2Fmicrobiology%2Fyukonriver_ak.html&size=6.9kB&name=Helicobacter_pylori.jpg&p=helicobacter+pylori&type=jpeg&no=2&tt=8,141&oid=395019b0d8c7a1a2&ei=UTF-8
  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    15/19

    %AT TO 'OO( )OR *

    "ASTRIC ULCER

    recent loss of "eight

    heartburn, indigestion, sharp

    abdominal fullness

    DU+DE8AL ULCER

    burning pain

    recent "eight gain

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    16/19

    Di&-nos!i% T#s!s

    B&ri$ S*&llo* / UGIS / S&ll Bo*#l

    S#ri#sGI En,os%o.' /

    Eso."&-o-&s!ro,$o,#nos%o.'

    1 Bio.s' &n, "is!olo-' *i!" %$l!$r#S!ool #2& &n, o%%$l! +loo,3BC Co$n!

    G&s!ri% s#%r#!or' s!$,i#sC&r+on456 Ur#& Br#&!" T#s!

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    17/19

    M&n&-##n!

    %o+in&!ion o &n!i+io!i%s7 .ro!on .$. in"i+i!ors7

    "is!&in# (H8) r#%#.!or &n!&-onis!

    &n!&%i,s

    -&s!ri% &s.ir&!ion

    s!r#ss r#,$%!ion &n, r#s!

    so0in- %#ss&!ion

    ,i#!&r' o,ii%&!ion

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    18/19

    +RGIA' -GT

    Total Gastrectomy . /sophago0e0unostomy

    1agotomy 2 surgical di$ision of the $agal ner$e

    Gastric resection . antrectomy

    Billroth I . Billroth II

    Pyloroplasty

  • 7/25/2019 Peptic Ulcer Dse Pathophysiology

    19/19

    3umping yndrome

    rapid emptying of the gastric contents into the smallintestine

    S4mptoms4 usually occur 56 mins pc

    abdominal cramping

    diarrhea

    palpitations

    tachycardia