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Úlcera péptica

Последний просмотренный: 16 Aug 2025
Last updated: 27 Feb 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • dor abdominal
  • "sinal de apontar"
Полная информация

Другие диагностические факторы

  • desconforto epigástrico
  • náuseas ou vômitos
  • saciedade precoce
  • perda de peso ou anorexia
  • diarreia
  • sintomas de anemia
  • sangramento gastrointestinal (GI)
  • choque hipotenso ou séptico
  • som de sucussão
Полная информация

Факторы риска

  • Infecção por Helicobacter pylori
  • uso de anti-inflamatórios não esteroidais (AINEs)
  • tabagismo
  • idade mais avançada
  • história pessoal de úlcera péptica
  • história familiar de úlcera péptica
  • paciente de terapia intensiva
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • teste respiratório para Helicobacter pylori ou teste do antígeno fecal
  • endoscopia digestiva alta
  • Hemograma completo
Полная информация

Исследования, проведение которых нужно рассмотреть

  • nível de gastrina sérica em jejum
  • ATG de abdome e pelve, com e sem contraste
  • arteriografia visceral
Полная информация

Алгоритм лечения

Острый

úlcera com sangramento ativo

sem sangramento ativo: Helicobacter pylori negativo

sem sangramento ativo: Helicobacter pylori positivo

ПРОДОЛЖЕНИЕ

recorrências frequentes, úlceras grandes ou refratárias

úlcera associada a anti-inflamatório não esteroidal refratária à terapia de supressão ácida

Составители

Авторы

Nimish Vakil, MD, FACP, AGAF, FASGE, FACG

Clinical Adjunct Professor

School of Medicine and Public Health

University of Wisconsin

Madison

WI

Раскрытие информации

NM is a consultant for Phathom Pharmaceuticals, Redhill Pharmaceuticals, and ISOThrive Inc. NM is an author of the Merck Manual.

Выражение благодарностей

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

Раскрытие информации

SM is on the speaker's bureau for Otsuka, the manufacturer of Helicobacter pylori breath-test kits. MMM declares that he has no competing interests.

Рецензенты

Lise Lotte Gluud, MD

Consultant

Gastrounit Medical Division

Copenhagen University Hospital Hvidovre

Copenhagen

Denmark

Раскрытие информации

LLG declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.Полный текст  Аннотация

Chey WD, Leontiadis GI, Howden CW, et al. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017 Feb;112(2):212-39.Полный текст  Аннотация

Laine L, Barkun AN, Saltzman JR, et al. ACG clinical guideline: upper gastrointestinal and ulcer bleeding. Am J Gastroenterol. 2021 May 1;116(5):899-917. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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