Perforation of ulcer

The perforation of an ulcer is a serious complication of peptic ulcer of the stomach or duodenum, in which perforation of the wall and the flow of contents of the stomach or intestine into the abdominal cavity occur. As a result, the patient develops peritonitis, which, in the absence of timely surgical intervention, can lead to a fatal outcome.

Symptoms of perforation of the ulcer

Since the duodenum is the upper part of the small intestine immediately behind the gastric gatekeeper, when the ulcer of the stomach and intestines is perforated, the common symptoms and localization of pain coincide.

Symptoms of perforation of the ulcer as a whole are divided into two groups:

  1. Basic. These include pain, tension of the abdominal wall, the presence of a peptic ulcer in the anamnesis.
  2. Auxiliary. These include changes in pressure, heart rate, body temperature, nausea, a symptom of free fluid in the abdominal cavity.

In the development of peritonitis during the perforation of the ulcer of the stomach or duodenum, three stages are distinguished, all with characteristic signs:

  1. Period of pain shock or period of chemical peritonitis. It lasts from 3 to 6 hours, depending on the filling of the stomach and the size of the perforation. Accompanied by acute dagger pain in the epigastric region, which by the end of the period subsides. The wall of the abdomen is tense, the skin is pale, sweating is intensified, the respiration is shallow and rapid, but the pulse usually remains within normal limits. Vomiting may occur.
  2. Period of bacterial peritonitis (imaginary well-being). At this stage, breathing becomes deeper and more even, the stomach relaxes, the patient feels considerable relief. Against this background, there is a further decrease in blood pressure, bloating, tachycardia, an increase body temperature, the patient's tongue is dry and a gray coating is formed on it.
  3. Period of diffuse peritonitis (acute intoxication). It begins usually after 12 hours after the appearance of the first symptoms of the disease. It is characterized by severe vomiting, leading to dehydration , a sharp decrease in previously high body temperature, dry and pale skin, a strong drop in blood pressure, and a pulse rate of 120 or more beats per minute. The abdomen is heavily swollen, urination is stopped, symptoms of acute intoxication, lethargy, delayed reaction to external stimuli are observed.