A patient presents with tachycardia, BP of less than 100 mm systolic and postural hypotension. Diagnosis is: September 2012

Ans: D i.e. Bleeding peptic ulcer GI ulcers (from surgery) MC site of duodenal ulcer: Duodenal cap Curling's ulcer: GI ulcers in severe burns Site of bleeding in duodenal ulcer: Gastroduodenal aery Treatment of perforated peptic ulcer: - Exploratory laparotomy, Nasogastric suction, - Acid suppression, - Antibiotics etc. Management of duodenal ulcer: - Highly selective vagotomy (least chances of diarrhea/ dumping syndrome) - Truncal vagotomy and antrectomy (lowest chances of recurrence) Cause of early dumping syndrome: Due to rapid emptying of hyperosmolar gastric contents into the small intestine