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A 44 year old lady has been having epigastric pains for the past 4 weeks.
A 44 year old lady has been having epigastric pains for the past 4 weeks.
gastric
PUD
epigastric pain that worsens with eating, postprandial belching and epigastric fullness, early satiety, fatty food intolerance, nausea, and occasional vomiting. hematemesis (either red blood or coffee-ground emesis), or melena (black, tarry stool). GERD.
Test for H.pylori, NASIDs use
gastric cancer
wt loss, bdominal pain tends to be epigastric, vague and mild early in the disease but more severe and constant as the disease progresses., dysphagia if at proximal stomach. Signs of tumor spread: enlarged virchow's node, ascites, palpable liver, enlarged ovary (krunkernberg tumor)
Gastroparesis
Nausea, vomiting, abdominal pain, early satiety, postprandial fullness, and bloating.
gastritis
Abdominal discomfort/pain, heartburn, nausea, vomiting, and hematemesis.
functional dyspepsia
bothersome postprandial fullness, early satiation; epigastric pain and burning that are unexplained after a routine clinical assessment; may be associated with nausea and vomiting, and exacerbated by psychosocial stressors
Hepatobiliary
Biliary colic
Intense, dull discomfort located in the RUQ or epigastrium. Associated with nausea, vomiting, and diaphoresis. Generally lasts at least 30 minutes, plateauing within 1 hour.
Budd Chiari
Symptoms include fever, abdominal pain, abdominal distention (from ascites), lower extremity edema, jaundice, gastrointestinal bleeding, and/or hepatic encephalopathy.
Portal vein thrombosis
Symptoms include abdominal pain, dyspepsia, or gastrointestinal bleeding.
pancreas
exocrine pancreatic cancer
asthenia, wt loss, anorexia, dark urine, jaundice, back pain diarrhoea, Thrombophlebitis
Signs: jaundice, hepatomegaly, RUQ mass, Cachexia, Courvoisier's sign, epigastric mass
Chronic pancreatitis
Epigastric pain radiating to the back. Fat malabsorption — Steatorrhea, loose, greasy, foul smelling stools that are difficult to flush. Pancreatic diabetes
cardiac
squeezing, tightness, pressure, constriction, strangling, burning, heart burn, fullness in the chest, band-like sensation, knot in the center of the chest, lump in throat, ache, heavy weight on chest,
family or past med hx
,
SOB