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Running Header: Peptic Ulcer and Pancreatitis

Peptic Ulcer and Pancreatitis

Jonathan Bland
Pathophysiology
Prof. Lori McGowan

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Running Header: Peptic Ulcer and Pancreatitis
Differentiate between pancreatitis and peptic ulcer. Pancreatitis is an inflammation of the

pancreas resulting from auto-digestion of the tissues. It may occur in acute or chronic form.
Acute pancreatitis is considered a medical emergency (Gould, 2006). When auto-digestion
occurs following premature activation of pancreatic proenzymes within the pancreas itself
(Gould, 2006), basically causing the proenzymes to attack the pancreatic tissue, leading to
massive inflammation, bleeding and necrosis (Gould, 2006). The treatments for acute
pancreatitis are usually started in the hospital with bed rest, intravenous (IV) fluids to replace lost
fluids this will also help maintain the patients blood pressure (WebMD, 2009). No food for 3 to
7 days and pain medication for the patient. For the patient with chronic pancreatitis, the
treatment is the same. Ongoing treatment would have the patient stop all alcohol intakes; alcohol
really damages the pancreas and often is the main culprit in pancreatitis attacks.
Peptic ulcers occur most commonly in the proximal duodenum (duodenal ulcers) but are
also found in the antrum of the stomach (gastric ulcers) or lower esophagus. They usually are
found single, small, round cavities with smooth margins that penetrate the submucosa. Once acid
or pepsin penetrates the mucosal barrier, the tissues are exposed to continued damage because
acid diffuses into the gastric wall (Gould, 2006). They slowly erode deeper into the tissues
causing pain and bleeding. Depending on the size of the wound depends on how much blood will
be released into the intestinal system. The person may not even know that he is losing blood only
blood tests can find that out, it will show up in an iron-deficiency anemia or occult blood in the
stool. This is the first sign of peptic ulcers. The treatment for this disease is to reduce the level of
acid in the digestive system, to relieve pain, and encourage healing. If the patient has a bacterial
infection because of the peptic ulcers, appropriate antibiotics will be given. Most ulcers can be
cured in 2 to 4 weeks.

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Running Header: Peptic Ulcer and Pancreatitis

Pathophysiology

Signs

Pancreatitis
Results from early activation of
pancreatic enzymes, producing autodigestion of the pancreas and surround
tissues. Digestive enzyme release is
amplified as acinar cells lyse, leading to
inflammation and necrosis.
Fever, tachycardia, and hypotension.
Abdominal examination reveals epigastric
tenderness, with localized guarding and
rebound. Sluggish or absent bowel sounds
indicate coexisting ileus (Conwell &
Stevens, 2011)

Possible Complications

Necrosis, pseudocyst (fluid collection),

abscess, ileus, fistulazation, GI
hemorrhage, phlegmon and
pseudoaneurysm. Distant or systemic
complications include shock, respiratory
failure, metabolic derangements such as
hypocalcemia, hyperglycemia,

Peptic Ulcer
Multiple processes that control acid and
pepsin secretion. H.pylori infections.

Burning pain from the naval to

breastbone, worse on empty stomach,
flare ups at night, temporarily relieved
by eating certain foods, may disappear
for days to weeks only to return.
Vomiting blood, dark stools, nausea
and vomiting, appetite changes and
weight loss.
Bleeding into your stomach or
duodenal wall, blood vessels may be
damaged; patient may become anemic
from the constant blood loss in chronic
condition; acute, death from massive
blood loss. A bacterial infection, H.
Pylori is often found.

coagulopathy and disseminated

intravascular coagulation Some of the
complications from pancreatitis are: low
blood pressure, heart failure, kidney
failure, ARDS (adult respiratory distress
syndrome), diabetes, ascites, accumulation
of fluid in the abdomen, and cysts or
abscesses in the pancreas.

Works Cited
Conwell, D., & Stevens, T. (2011). Acute Pancreatitis. Retrieved March 20, 2011, from Cleveland Clinic:
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/gastroenterology/ac
ute-pancreatitis/#cesec4

Gould, B. E. (2006). Pathophysiology for the Health Professionals, 3rd Edition. Philadelphia: W.B.
Sauders.

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Running Header: Peptic Ulcer and Pancreatitis
Mayo Clinic. (2011). Peptic Ulcers. Retrieved March 20, 2011, from MayoClinic:
http://www.mayoclinic.org/peptic-ulcers/

WebMD. (2009, June 30). Pancreatitis-Treatment Overview. Retrieved March 20, 2011, from WebMD:
http://www.webmd.com/digestive-disorders/tc/pancreatitis-treatment-overview