Perforating ulcer

A perforated ulcer (u. perforativum; synonym perforating) is an ulcer of the stomach or duodenum, leading to perforation (perforation) of the organ wall with the development of peritonitis.

The cause of a perforated ulcer is most often the long course of a common peptic ulcer. Less commonly, the causes may be acute ulcers that occur due to stress, serious illnesses, or taking certain medications.

Clinical manifestations of a perforated ulcer: sudden severe abdominal pain, often radiating to the back; nausea and vomiting; bloating and lack of stool and gas due to intestinal paresis.

Diagnosis is based on the clinical picture, blood tests, radiography and laparoscopy. The only treatment is surgical - suturing the perforation, sanitation and drainage of the abdominal cavity. The prognosis is serious, mortality reaches 10-20%. Prevention consists of timely detection and treatment of peptic ulcer.

Perforated ulcer - (u. perforata, u. perforativa, u. eperforata - - perforating ulcer - an acute limited infectious-allergic disease manifested by necrosis and inflammation of the adjacent wall of the stomach or duodenum, usually with pyloric stenosis. This is a severe complication of an acute ulcer . More often occurs in the pyloroduodenal zone, less often at the fundus and in the body of the stomach. The pathogen causing perforated ulcers has not yet been precisely established, but histologically it demonstrates Yersin's bacillus and other infectious agents with a negative blood culture. It is assumed that the damage to ulcers is accompanied by toxic-septic liver damage, systemic inflammatory response syndrome in the form of fever, intoxication, rapid progression of the disease and even the development of sepsis. Treatment from 2 to 5 months. The prognosis is favorable. Cases of death are rare. A perforated ulcer is characterized by the development of acute pain in the epigastric region, later spreading to the right hypochondrium with irradiation to the back, around the navel. The body temperature is low-grade, general malaise and pale skin are noted. The pain can be intense, unbearable, indomitable. Sometimes the patient’s condition is almost satisfactory, however, the clinical picture and clinic of intestinal obstruction develop over time. Unlike perforation, vomiting and tachycardia appear. Peritoneal breathing is heard on auscultation. Dry mouth is characteristic. The abdomen gradually becomes tense, there are no symptoms of peritoneal irritation, and only sometimes a gelatinous protrusion appears. A plain radiograph shows a clearing of free gas in the left iliac fossa, followed by a bladder filled with bile. Characterized by significant dilatation of the proximal duodenum and greater curvature of the stomach. When auscultating the esophagus in the epigastric region, an echoic noise resembling a splashing noise can be heard. To establish a diagnosis, laboratory and instrumental research methods are required: *X-ray examination. *Ultrasound of the abdominal cavity. *Laparoscopy. *Blood chemistry.