DVBCWST1 ;ALB/CMM STOMACH, DUODENUM, AND PERITONEAL ADHESIONS WKS TEXT - 1 ; 5 MARCH 1997 ;;2.7;AMIE;**12**;Apr 10, 1995 ; ; TXT ; ;;A. Review of Medical Records: ;; ;; ;; ;;B. Medical History (Subjective Complaints): ;; ;; 1. Vomiting. ;; ;; ;; 2. Hematemesis or melena (describe any episodes). ;; ;; ;; 3. Treatment - type, duration, response, side effects. ;; ;; ;; 4. Circulatory disturbance after meals, hypoglycemic reactions ;; (state time of onset in relation to meals, frequency). ;; ;; ;; 5. Diarrhea, constipation. ;; ;; ;; 6. Episodes of colic, distention, nausea, and/or vomiting - ;; frequency, duration, and severity. ;; ;; ;;C. Physical Examination (Objective Findings): ;; ;; Address each of the following and fully describe current findings: ;; 1. Specific site of any ulcer disease. ;; ;; ;; 2. Weight gain or loss. ;; ;; ;; 3. Signs of anemia. ;; ;; ;; 4. Pain or tenderness - location, type, precipitating factors. ;; ;; ;;D. Diagnostic and Clinical Tests: ;; ;; 1. For gastritis, endoscopic evidence - describe hemorrhage, ;; ulcerated or eroded areas. ;; 2. For adhesions, X-ray to show partial obstruction, delayed ;; motility. ;; 3. Include results of all diagnostic and clinical tests conducted ;; in the examination report. ;; ;; ;;E. Diagnosis: ;; ;; ;;Signature: Date: ;;END