A 30-year-old male banker complains of mid-epigastric gnawing and boring pain fo

Question

A 30-year-old male banker complains of mid-epigastric gnawing and boring pain for the last week. The pain is worse at night and is somewhat better immediately after he eats. He has not had any fever, nausea, or vomiting. He takes about one 500-mg acetaminophen tablet a week for headaches but does not take any other medications.Upper endoscopy reveals a 2-cm mucosal defect in the antrum of the stomach. There is mild edema in the adjacent mucosa, but there is no thickening of the edges of the ulcer. What is the most likely diagnosis? What are complications from this condition? What is the most likely mechanism of this disorder?

Explanation / Answer

The most likely diagnosis is peptic ulcer.

complications: gastric carcinoma and perforation with bleeding

mechanism: Infection with Helicobacter pylori. This pathogen produces protease and urease of bacteria. These enzymes damage the mucus layer of the stomach.

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