About the patient
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Case presentation:
Samuel presented with a complex medical history and a month-long struggle with intermittent, burning epigastric abdominal pain of moderate intensity. The pain radiated towards his back in a band-like fashion. Alongside his pain, he experienced nausea and vomited once, with the vomit containing food particles. Interestingly, Samuel denied exhibiting signs and symptoms of melena, hematochezia, or hematemesis. On further examination, Samuel’s abdomen appeared soft and non-distended, with bowel sounds present in all four quadrants. Mild tenderness was noted over the epigastrium. Laboratory findings revealed a hematocrit of 39.3%, within normal limits otherwise. Imaging studies, including an upper gastrointestinal series, unveiled an accessory tract within the pylorus. An esophagogastroduodenoscopy uncovered incidental findings of two separate pylorus openings into the small intestine, alongside clean-based gastric and duodenal bulb ulcers. Biopsies for Helicobacter pylori returned negative.1a Pg1
Medical History:
His medical history was significant for peptic ulcer disease, and the patient had multiple endoscopies in the past 5 years. It was reported that he had 2 clean-based antral ulcers 5 years prior and was started on lansoprazole, which he could not afford and so was switched to Omeprazole, which he used intermittently. He also admitted to past use of an over-the-counter analgesic. 1a Pg1