Last reviewed: March 2019
Last updated: February  2019

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal pain
  • "pointing sign"

Other diagnostic factors

  • epigastric tenderness
  • nausea or vomiting
  • early satiety
  • weight loss or anorexia
  • diarrhea
  • symptoms of anemia
  • gastrointestinal (GI) bleeding
  • hypotensive or septic¬†shock
  • succussion splash

Risk factors

  • Helicobacter pylori infection
  • nonsteroidal anti-inflammatory drug (NSAID) use
  • smoking
  • increasing age
  • personal history of peptic ulcer disease
  • family history of peptic ulcer disease
  • patient in intensive care

Diagnostic investigations

1st investigations to order

  • Helicobacter pylori urea breath test or stool antigen test
  • upper gastrointestinal endoscopy
  • CBC
Full details

Investigations to consider

  • fasting serum gastrin level
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor of Clinical Medicine

Division of Gastroenterology

Department of Medicine

Hospital of the University of Pennsylvania

University of Pennsylvania

Perelman School of Medicine

Philadelphia

PA

Disclosures

KLL declares that she has no competing interests. 

Dr Kristle Lynch would like to gratefully acknowledge Dr Marty M Meyer and Dr Steven Moss, previous contributors to this topic.

Peer reviewers VIEW ALL

Consultant

Gastrounit Medical Division

Copenhagen University Hospital Hvidovre

Copenhagen

Denmark

Disclosures

LLG declares that she has no competing interests.

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