Gastric Conditions, Differential Diagnoses, Diagnostics, and Management

Condition Differential Relevant Diagnostics Non-Surgical Surgical

Diagnoses Management Managemen
t
Peptic Ulcer 1. Gastritis 1. Endoscopy - Proton Pump - Perforation
Disease 2.Gastroesophag 2. H. pylori testing 3. Inhibitors repair -
eal Reflux Urea breath test (PPIs) - H. Vagotomy
Disease (GERD) pylori (in refractory
eradication cases)
therapy -
Lifestyle
modifications
Zollinger- 1. Gastrinoma 1. Serum gastrin - High-dose - Tumor
Ellison 2. Chronic levels PPIs - resection -
Syndrome Gastritis 2. Secretin stimulation Somatostatin Partial
test analogs gastrectomy
3. Endoscopic
ultrasound
Stress Gastritis 1. Peptic Ulcer 1. Endoscopy - PPIs and H2 - Hemostasis
& Stress Ulcer Disease 2. Serum hemoglobin blockers - via
2. Acute Gastric 3. Stool occult blood Sucralfate - endoscopic
Mucosal Lesions test Prophylaxis in therapy -
ICU patients Surgical
oversewing
of bleeding
vessel
Atrophic 1. Pernicious 1. Serum vitamin B12 - Vitamin B12 - Rarely
Gastritis Anemia levels supplementati needed,
2. H. pylori- 2. Intrinsic factor on - H. pylori unless severe
induced gastritis antibodies eradication (if dysplasia
3. Gastric biopsy present) develops
Adenocarcino 1. Gastric 1. Endoscopy with - - Partial or
ma of the Lymphoma biopsy Chemotherapy total
Stomach 2. Peptic Ulcer 2. CT scan for staging - Radiation gastrectomy
Disease 3. Tumor markers therapy
(CEA, CA 19-9) (palliative)
Gastric 1. Gastric 1. Endoscopic biopsy - H. pylori - Surgery if
Lymphoma Adenocarcinoma 2. PET/CT scan eradication complication
2. MALT 3.Immunohistochemis (for MALT s arise
lymphoma try lymphoma) -
Chemotherapy
(CHOP
regimen)
Gastrointestin 1. Leiomyoma 1. CT scan - Tyrosine - Surgical
al Stromal 2. Gastric 2. Endoscopic biopsy kinase resection
Tumor (GIST) Adenocarcinoma 3. CD117 inhibitors with clear
immunostaining (imatinib) margins
Gastric 1. Carcinoid 1. Serum - Somatostatin - Surgical
Neuroendocrin Tumors chromogranin A analogs - excision
e Tumors 2. Zollinger- 2. Octreotide scan Watchful
Ellison 3. Endoscopic biopsy waiting for
Syndrome small tumors
Benign Gastric 1.Gastrointestina 1. Endoscopy - Symptom - Excision if
Neoplasms l Stromal Tumor 2. CT scan management symptomatic
(Leiomyoma, 2. Gastric Polyps 3. Histopathology (prokinetics
Lipoma, for
Gastroparesis) gastroparesis)
- Dietary
modifications
Massive Upper 1. Esophageal 1. Endoscopy - IV fluids, - Endoscopic
Gastrointestin Varices 2. Hemoglobin levels blood coagulation
al Bleeding 2. Peptic Ulcer 3. Coagulation profile transfusion - or clipping -
Disease PPIs Surgery if
bleeding
persists
Isolated 1. Esophageal 1. Endoscopy - Beta- - TIPS
Gastric Varices 2. Portal Doppler blockers - (transjugular
Varices 2. Portal Ultrasound Endoscopic intrahepatic
Hypertension 3. Liver Function sclerotherapy portosystemi
Tests c shunt)
Ménétrier’s 1. Gastric 1. Endoscopic biopsy - PPIs - -
Disease Lymphoma 2. Serum protein Cetuximab Gastrectomy
(Hypertrophic 2. Zollinger- levels (anti-EGFR if severe
Gastropathy) Ellison 3. CT scan therapy)
Syndrome
Watermelon 1. Gastric 1. Endoscopy - Iron - Rarely
Stomach Varices 2. Gastric biopsy supplementati needed
(Gastric 2. Gastric 3. Anemia workup on -
Antral Anemia Endoscopic
Vascular therapy (argon
Ectasia) plasma
coagulation)
Dieulafoy’s 1. Peptic Ulcer 1. Endoscopy - PPIs - - Surgical
Lesion Disease 2. Angiography Endoscopic excision if
2. Gastric AVM 3. Hemoglobin levels coagulation refractory
Bezoars & 1. Foreign Body 1. Endoscopy - Enzymatic - Surgical
Diverticula Ingestion 2. CT scan dissolution removal if
2. Gastroparesis 3. Barium swallow (for bezoars) - obstructing
study Dietary
adjustments
Mallory-Weiss 1. Esophageal 1. Endoscopy - PPIs - - Endoscopic
Syndrome Varices 2. Hemoglobin levels Supportive therapy if
2. Peptic Ulcer 3. Coagulation profile care severe
Disease
Volvulus 1. Gastric Outlet 1. X-ray (double - Nasogastric - Surgery
Obstruction bubble sign) decompressio (gastric
2. Small Bowel 2. Upper GI contrast n - IV fluids fixation or
 Obstruction study resection)
3. CT scan
Dumping 1. Functional 1. Glucose tolerance - Dietary -
Syndrome Dyspepsia test modifications Reconstructi
2. Reactive 2. Gastric emptying (small ve gastric
Hypoglycemia study frequent surgery
3. Endoscopy meals) -
Acarbose
(alpha-
glucosidase
inhibitor)
Postgastrecto 1. Short Bowel 1. Endoscopy - Nutritional - Corrective
my Problems Syndrome 2. Blood tests (CBC, supplements - surgery for
(Diarrhea, 2. Malabsorption iron, B12, calcium) Prokinetics for obstruction
Gastric Stasis, Syndromes 3. Gastric motility stasis or bile reflux
Bile Reflux, study
Anemia, Bone
Disease,
Weight Loss,
Gallstones)
Laparoscopic 1. Open 1. Pre-op imaging - Post-op -
Gastric Gastrectomy (CT/MRI) nutrition Laparoscopic
Operations 2. Bariatric 2. Post-op endoscopy counseling - gastrectomy
(Complications Surgery 3. Nutritional workup Medication or bypass
& Indications) for GERD
Abdominal Wall, Omentum, Mesentery, and Retroperitoneum: Differential
Diagnoses, Diagnostics, and Management

Condition Differential Relevant Non-Surgical Surgical

Diagnoses Diagnostics Management Management
Congenital 1. Omphalocele 1. Prenatal - Nutritional support - Surgical
Abnormalities 2. Gastroschisis ultrasound - Infection closure
of the 2. Postnatal prevention (primary or
Abdominal physical staged repair)
Wall exam 3. X-
ray
Acquired 1. Incisional 1. Clinical - Abdominal binder - Hernia
Abnormalities Hernia examination - Physiotherapy for repair (open
of the 2. Rectus 2. Ultrasound mild diastasis or
Abdominal Diastasis 3. MRI (for laparoscopic)
Wall complex
cases)
Sclerosing 1. Inflammatory 1. CT scan - Corticosteroids, - Surgical
Mesenteritis Bowel Disease 2. (fat ring sign) Tamoxifen - excision (if
Mesenteric 2. Biopsy Immunosuppressive causing
Ischemia 3. ESR/CRP therapy obstruction)
levels
Mesenteric 1.Lymphangioma 1. Abdominal - Observation if - Surgical
Cysts 2. Duplication ultrasound asymptomatic resection if
Cyst 2. CT/MRI symptomatic
3. Fine-
needle
aspiration (if
indicated)
Mesenteric 1.Gastrointestinal 1. Contrast- - Chemotherapy for - Surgical
Tumors Stromal Tumor enhanced CT malignant tumors - resection
(GIST) 2. Biopsy Targeted therapy
2. Liposarcoma 3. Tumor (e.g., imatinib for
markers GIST)
Retroperitoneal 1. Psoas Abscess 1. Blood - IV antibiotics - - Surgical
Infections 2. Perinephric cultures Drainage via drainage (if
Abscess 2. CT scan percutaneous large or
3. CBC approach refractory)
(elevated
WBCs)
Retroperitoneal 1. Malignancy- 1. MRI - Corticosteroids, - Surgical
Fibrosis Associated 2. Biopsy Tamoxifen - ureterolysis if
Fibrosis 3. Ureteral Stenting for ureteric severe
2. Tuberculosis imaging (to compression
assess
compression)
Esophageal Conditions: Differential Diagnoses, Diagnostics, and Management

Condition Differential Relevant Diagnostics Non-Surgical Surgical

Diagnoses Management Manageme
nt
Gastroesopha 1. Eosinophilic 1. 24-hour pH - Proton pump - Nissen
geal Reflux Esophagitis monitoring inhibitors fundoplicati
Disease 2. Esophageal 2.Esophagogastroduoden (PPIs) - on
(GERD) Motility oscopy (EGD) Lifestyle
Disorder 3. Esophageal modifications
manometry
Giant Hiatal 1.Paraesophage 1. Barium swallow study - Acid -
Hernia al Hernia 2. CT scan suppression Laparoscopi
2.Diaphragmati 3. Upper endoscopy therapy (PPIs) c hiatal
c Rupture - Observation hernia
if repair
asymptomatic
Schatzki’s 1. Peptic 1. Barium swallow study - Esophageal -
Ring Stricture 2. Endoscopy dilation - Acid Endoscopic
2. Eosinophilic 3. Biopsy (to rule out suppression dilation if
Esophagitis eosinophilic esophagitis) therapy refractory
Eosinophilic 1. GERD 1. Endoscopic biopsy - Dietary -
Esophagitis 2. Achalasia (eosinophilic infiltration) modification Esophageal
2. pH monitoring (allergen dilation for
3. Barium swallow avoidance) - severe
Topical strictures
corticosteroids
Motility 1. GERD 1. Esophageal - Calcium - Heller
Disorders of 2.Pseudoachalas manometry channel myotomy -
the ia 2. Barium swallow blockers, Peroral
Esophagus ("bird-beak" sign in nitrates - Botox endoscopic
(Achalasia, achalasia) injections myotomy
Diffuse 3. EGD (temporary (POEM)
Esophageal relief)
Spasm)
Esophageal 1. Peptic 1. EGD with biopsy - -
Cancer Stricture 2. CT scan (staging) Chemoradiothe Esophagect
(Carcinoma 2. Esophageal 3. PET scan (metastasis rapy for omy
of the Lymphoma assessment) localized (minimally
Esophagus) disease - invasive or
Palliative care open)
for advanced
cases
Esophageal 1. Boerhaave 1. CT scan with contrast - IV antibiotics - Surgical
Perforation Syndrome 2. Esophagogram - NPO with repair or
2. Mallory- 3. Chest X-ray enteral endoscopic
Weiss Tear (pneumomediastinum) nutrition stenting
Mallory- 1. Esophageal 1. Endoscopy - Supportive -
Weiss Varices 2. CBC (for anemia) care (IV fluids, Endoscopic
Syndrome 2. Boerhaave 3. Coagulation profile PPI) - hemostasis
Syndrome Transfusion if (clips,
needed coagulation)
Caustic 1. Infectious 1. Endoscopy (within - IV fluids, -
Injury Esophagitis 24-48 hours) pain control - Esophagect
2. Chemical 2. CT scan (for Steroids omy for
Burns perforation) (controversial) severe
3. Chest X-ray (if strictures
suspecting mediastinitis)
Acquired 1. Esophageal 1. Barium swallow - Nutritional - Surgical
Esophageal Cancer 2. Endoscopy support - repair with
Fistula 2. Tuberculous 3. CT scan Stenting for reconstructi
Fistula palliation on
Esophageal 1. Esophageal 1. Barium swallow - Nutritional - Colonic
Reconstructio Stricture 2. Endoscopy support - interpositio
n (Post- 2.Tracheoesoph 3. CT scan Esophageal n or gastric
Esophagecto ageal Fistula dilation if pull-up
my) minor stricture