Gastric Ulcer (Ulcus Ventriculi): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing).
      • Skin, mucous membranes and sclerae (white part of the eye).
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Auscultation (listening) of the heart.
    • Auscultation of the lungs [due topossible cause: chronic lung disease (such as chronic obstructive pulmonary disease (COPD)]
    • Examination of the abdomen (abdomen)
      • Percussion (tapping) of the abdomen
        • Meteorism (flatulence): hypersonoric tapping sound.
        • Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
        • Cholelithiasis (gallstones): knocking pain over the gallbladder region and the right lower ribcage.
      • Palpation (palpation) of the abdomen (abdomen) pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?) [pain in the upper abdomen (often occurs after food intake (food-dependent pain); possibly also occurring independently of food intake)][due todifferential diagnoses:
        • Functional dyspepsia (irritable stomach syndrome).
        • Gastritis (gastritis)
        • Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
        • Ulcus duodeni (duodenal ulcer)]

        [due topossible secondary diseases:

        • Gastrocolic fistulas (unphysiological connections between the stomach and colon).
        • Gastric outlet stenosis (narrowing of the gastric outlet).
        • Gastric bleeding
        • Gastric perforation (stomach rupture)
        • Penetration of the ulcer (penetration of the ulcer from the stomach into adjacent organs such as the pancreas (pancreas))]
  • Cancer screening [due todifferential diagnoses:
    • Gastric carcinoma (stomach cancer)
    • Pancreatic carcinoma (pancreatic cancer)]

    [due topossible sequelae:

    • Gastric carcinoma (stomach cancer)
    • MALT lymphoma (lymphoma of the mucosa-associated lymphoid tissue, MALT); so-called extranodal (arising outside the lymph nodes) lymphomas; about 50% of all MALT lymphomas are diagnosed in the stomach (80% in the gastrointestinal tract); MALT lymphomas are highly favored in their development by chronic infections with the bacterium Helicobacter pylori resp. favored by inflammation; by an Erdikationstherapie (antibiotic therapy) disappear not only the bacteria, but as a result in 75% of cases also the gastric lymphoma]
  • Urological examination [due topossible causes: chronic renal insufficiency (kidney weakness);nephrolithiasis (kidney stones)]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.