Question

Diagnosis: Peptic ulcer with partial gastric outlet obstruction Case Study Discussion – Part II: Answer the following and post your response as an additional response to your original Part I thread. Reflecting back on your previous post, how successful were you in identifying the possible diagnosis? What aspects from the case study were the most relevant in order to help confirm this diagnosis? Formulate a treatment plan and support your plan of care by incorporating evidence based rationale. What is the goal of treatment? What follow up would you recommend? Be sure to include any important patient education.

Answer 1

The most common cause of Gastric outlet obstruction is a peptic ulcer. The presence of H.pyroli in the peptic ulcer case increases the complication of Gastric outlet obstruction. In Crohn's disease, the duodenal is also involved in obstruction. pancreatitis, polyps, and gastric tuberculosis are the least common causes for gastric outlet obstruction. The clinical syndrome of epigastric pain vomiting, weight loss, abdominal distension, and lab diagnostic test results helps to confirm the diagnosis. The goal of treatment is to alleviate the obstruction, preventing secondary complications and promoting health. The treatment plan is to treat the underlying cause of peptic ulcer disease. Reduction of Hydrochloric acid by use of proton pump inhibitor to prevent further inflammation and complication. Replacement of fluid and electrolyte balances to replace the electrolytes. Nasogastric suctioning helps to clear the gastric secretions. Administer parental nutrition and plan for surgery based on medical therapies are not worked out. follow up of the patient with lab tests and a diagnostic test to detect the condition and use of alternative therapies. Health education includes hygienic measures to prevent reoccurrence of the infection, parenteral nutrition, and postoperative complications.