The picture above shows the endoscopic view of a Duodenal Ulcer in the first part of duodenum(=Duodenal Bulb=D1)
Typically, it's being thought to medical students and also assumed by patients that Duodenal Ulcer presents with Upper Abdominal symptoms such as pain, discomfort or bloatedness.
Like many other diseases, Duodenal Ulcer sometimes present with atypical symptoms.
The patient above initially presented to the Urologist in our hospital with Left abdominal pain. The initial clinical impression was Left Renal Colic.
However, thorough investigations of the Kidney systems from Urine analysis to CT Urography were all normal.
The Urologist then referred to for Colonoscopy to assess the Colon especially the Left Colon.
However upon thorough clinical history appraisal, the left-sided abdominal pain was deemed to enclose the whole of the left abdomen from the left upper part to the left lower part.
As such, I had decided to also examine the stomach and duodenum apart from colonoscopy.
The Duodenal Ulcer above was discovered at Upper Gastrointestinal Endoscopy(OesophagoGastroDuodenoScopy=OGDS).
Clinical lessons;
1.It is worthwhile to repeat thorough clinical appraisals by different doctors in less straightforward clinical cases
2.It is worthwhile for Clinical Specialist performing special invasive procedures especially that require some form of anaesthesia to have a lower threshold of clinical indications so as to save time and resources.
