A 54-year-old woman presented with a one-month significant history of recurrent, burning epigastric abdominal pain with moderately severe intensity. She had nausea and vomiting once. Moreover, she had the significant medical history of peptic ulcer disease for which she had multiple endoscopies in the last 6 years.
Likewise, her past medication history revealed the initial administration of lansoprazole followed by omeprazole. Later, she used over the counter analgesics such as acetaminophen, aspirin, and caffeine. Examination: Abdomen: Soft and nondistended Bowel sounds: Present in all 4 quadrants Epigastrium: Presence of mild tenderness Hematocrit: 39.3% Basic laboratory findings: Normal An esophagogastroduodenoscopy (EGD): 2 separate opening of the pylorus into the small intestine with clean-based gastric and duodenal bulb ulcers (image attached) Biopsies for Helicobacter pylori:…
