Duodenal Ulcers

Duodenal ulcers tend to cause more consistent pain than does gastric ulcers.

Pain is absent when the patient awakens but appears in mid-morning and is relieved by food but recurs 2 to 3 h after a meal.

Pain that awakens a patient at night is common and is highly suggestive of duodenal ulcer.

In neonates, perforation and hemorrhage may be the first manifestation of duodenal ulcer.

Hemorrhage may also be the first recognized sign in later infancy and early childhood, although repeated vomiting or evidence of abdominal pain may be a clue.

Majority the result of H pylori infection or NSAID’S.

DUs more common in patients with antral-predominant H pylori gastritis, with destruction of somatostatin-producing D cells leads to increased gastrin acid load to the duodenum.

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