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Perforated Ulcer

Perforated Ulcer

A perforated ulcer is a condition in which an ulcer burns through the walls of the stomach and causes the digestive juices and other acids to flow into the abdominal cavity. In this following HealthHearty article, we will go into more detail about this condition.
Kundan Pandey
Last Updated: Apr 24, 2018
Handy Tip

Do not ignore stomach pain, especially one that comes about at regular intervals. This is one of the first signs of this condition. Make sure to get yourself examined.

A perforated ulcer, also known as a gastric perforation or peptic ulcer, is a serious medical condition in which an (already formed) untreated ulcer burns through the walls of the stomach or any other section of the gastrointestinal tract, thereby allowing the digestive juices and other stomach acids to flow into the abdominal cavity, causing severe inflammation of the stomach.

Causes
The most common cause for the onset of this condition is due to a bacterial infection that is caused by the Helicobacter pylori bacterium. These bacteria are responsible for spreading of over 60% of stomach ulcers.

Other causes may include a high dosage and regular intake of non-steroidal anti-inflammatory drugs (NSAIDs), as well as smoking and intake of alcohol. Other than these, the ulcer could also be brought on due to internal trauma or other diseases of the stomach.

Symptoms
The most common symptom of this condition is a burning pain or a sensation in the abdomen, located between the navel and the breastbone. The pain may be erratic and vary in the degrees of intensity―though the pain has generally been described as extremely intense and numbing. So intense, in fact, that actions like coughing, sneezing, touching, and laughing could intensify the same. This pain could be preceded by days or weeks of mild pain in the same region (between the navel and breastbone), as well as passage of dark stools. Dark stools could be an indication of bleeding of an ulcer. If the bleeding is mild, it may not show, but a heavily bleeding ulcer will usually reflect in the stools.

Some other signs of this condition include nausea, vomiting, loss of appetite, rapid heartbeats, excessive sweating, fainting, and sudden weight loss.

Diagnosis
There are various methods for diagnosing perforated ulcers. They are endoscopy, barium meal, biopsy, and C14 breath tests. In endoscopy tests, a flexible tube is inserted in the esophagus. The endoscope is observed under a camera fitted in it which helps the doctor in observing the ulcer. In a biopsy test, a small tissue sample is tested, and after the test, the ulcer is confirmed.

Complications
Perforated ulcers may lead to various complications if the ulcer is not treated on time. Some of the most common problems related to this medical condition include bleeding, perforation (hole), and narrowing and obstruction of the stomach walls. Bleeding ulcers erode the stomach walls and the blood may slowly seep into the digestive tract. The patient may feel dizzy and weak. Peritonitis, an inflammation of the abdominal cavity wall, could be brought on due to this condition. Along with that, swelling and scarring of the duodenum may occur due to these ulcers as well.

Treatment
This is one of the few conditions in which the treatment method opted for is surgery. The condition can cause complications and even prove to be fatal if timely action is not taken. A laparotomy (incision made in the stomach walls to examine organs) needs to be carried out immediately to check for the severity of the condition―a thorough inspection of the abdominal cavity, including the stomach and the duodenum is done to determine the exact location of the perforation.

The kind of surgical procedure to opt for is determined on the basis of the size of the perforation, the duration of the symptoms, the patient's history of suffering from the condition, hemodynamic instability, and other life-threatening comorbid conditions. Some of the common surgeries that are recommended for treatment are vagotomy, antrectomy and pyloroplasty.

Along with the surgical procedures, the treatment of the underlying H pylori infection should also be undertaken, as should the cessation of NSAIDs. Post surgery, the diet of the patient plays a major role in the effective recuperation and treatment. A consultation with the physician is, therefore, absolutely necessary in order to draw a plan.

Perforated ulcers are some of the few conditions that require a surgery for their timely treatment. Which is why it is important to get the diagnosis in order and follow it up with a proper treatment of the same.

Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.