Penetrating Ulcer of the Stomach and Duodenum

Penetrating ulcer of the stomach and duodenum

Penetration of a stomach or duodenal ulcer into nearby organs and tissues is called penetration. There are 3 stages of penetration: 1) penetration of the ulcer through all layers of the organ wall, 2) fibrous fusion of the ulcer with the underlying tissues, 3) completed penetration.

The clinical picture depends on the location of the ulcer and the organ into which it penetrates. Stomach ulcers often penetrate into the lesser omentum - there is severe pain that is difficult to relieve conservatively. Duodenal ulcers often penetrate into the pancreas, which causes pain and hyperamylasemia radiating to the lower back.

Possible complications of a penetrating ulcer:

1. Perforation into the abdominal cavity, development of peritonitis
2. Profuse bleeding from the vessels of the omentum or pancreaticoduodenal artery

Diagnosis is based on x-ray and endoscopic examinations.

Treatment is surgical only after preparatory conservative treatment. For a gastric ulcer - resection, for a duodenal ulcer - vagotomy and antrum resection.

The prognosis is favorable. Prevention - timely adequate treatment of peptic ulcer, including surgery.