What will be the likely diagnosis in a thiy year old male presenting with epigastric pain radiating to back that wakes him up at night and is relieved by consuming food. He has a past history of surgery for a perforated duodenal ulcer, treated with omental patch and proton pump inhibitors and analgesics:
Epigastric pain relieved by food that awakens the patient of night (when stomach is empty) suggests a diagnosis of duodenal ulcer. Gastric ulcer pain is exacerbated by food and usually does not awaken the patient at night. Pancreatic pain is not relieved by food & is typically relieved by bending forwards & worsened on lying down. Ref: Bailey and Love Sho Practice of Surgery 24th Edition, Page 1038-9; Current Diagnosis & Treatment in Surgery (CSDT) 13th Edition, Page85.
Atrophic Gastritis
Duodenal Ulcer
Gastric Ulcer
Chronic Pancreatitis