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Penetrating gastric ulcer (into pancreas) Helicobacter pylori gastritis

Stollings LMS - MedPix (2009)

View Article: MedPix Image - MedPix Case

Affiliation: Childrens Hospital of Dayton, OH

ABSTRACT

Diagnosis: Penetrating gastric ulcer (into pancreas) Helicobacter pylori gastritis

History: This is a 13 y.o. boy with recurrent iron deficiency anemia since age four, managed with chronic iron supplementation. Recent recurrence of anemia in the last 6 weeks accompanied by epigastric pain, and several episodes of emesis. Two episodes of vomiting contained blood (hematemesis).

Findings: Abdominal ultrasound: Hypoechoic heterogeneous mass in the head of the pancreas extending along the body of the pancreas with reactive lymph nodes anterior to the pancreas head. Abdominal CT with contrast: Enlarged pancreatic head with edema at the junction of the head and body and disruption anteriorly. Marked gastric wall thickening and distention with a collection of fluid along the posterior stomach wall.

Ddx: • Gastric Ulcer disease (H. pylori vs hyperacidity) • Trauma with pancreatic laceration • Walled-off perforation • Pancreatic pseudocyst • Pancreatitis

Dxhow: EGD (Endoscopy) with biopsy

Exam: Generally well developed, thin, pale male. Abdomen is soft, non-tender, non-distended without masses or organomegaly. Labs: Hgb 9.8, Hct 32.7, MCV 71.1, Reticulocyte count 2.6, WBC 6.6, platelets 570, stool guaiac positive, CRP 3.86, ESR 23, iron 11. Amylase and lipase are within normal limits.

No MeSH data available.


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Penetrating gastric ulcer (into pancreas) Helicobacter pylori gastritis

Stollings LMS - MedPix (2009)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1368&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Childrens Hospital of Dayton, OH

ABSTRACT

Diagnosis: Penetrating gastric ulcer (into pancreas) Helicobacter pylori gastritis

History: This is a 13 y.o. boy with recurrent iron deficiency anemia since age four, managed with chronic iron supplementation. Recent recurrence of anemia in the last 6 weeks accompanied by epigastric pain, and several episodes of emesis. Two episodes of vomiting contained blood (hematemesis).

Findings: Abdominal ultrasound: Hypoechoic heterogeneous mass in the head of the pancreas extending along the body of the pancreas with reactive lymph nodes anterior to the pancreas head. Abdominal CT with contrast: Enlarged pancreatic head with edema at the junction of the head and body and disruption anteriorly. Marked gastric wall thickening and distention with a collection of fluid along the posterior stomach wall.

Ddx: • Gastric Ulcer disease (H. pylori vs hyperacidity) • Trauma with pancreatic laceration • Walled-off perforation • Pancreatic pseudocyst • Pancreatitis

Dxhow: EGD (Endoscopy) with biopsy

Exam: Generally well developed, thin, pale male. Abdomen is soft, non-tender, non-distended without masses or organomegaly. Labs: Hgb 9.8, Hct 32.7, MCV 71.1, Reticulocyte count 2.6, WBC 6.6, platelets 570, stool guaiac positive, CRP 3.86, ESR 23, iron 11. Amylase and lipase are within normal limits.

No MeSH data available.