acute perforation of ulcer
Introduction
Introduction to acute perforation of ulcer disease Acute perforation of ulcer disease is one of the serious complications of ulcer disease. Among all ulcer patients, acute perforation accounts for about 10-15%. The majority of ulcer perforation is duodenal ulcer perforation, and the ratio of perforation of gastric ulcer is 15:1. The acute perforation of ulcer disease is acute and rapid, and if it is not treated in time, it may be life-threatening due to peritonitis. Perforation of ulcer disease is the result of active ulceration gradually eroding deep into the serosal membrane. As a result of acute perforation of ulcer disease, about 70% have a long history of ulcer disease, and the symptoms of ulcer disease are aggravated before perforation, about 10%. The patient does not have a history of ulcers, but a perforation occurs suddenly. Before perforation, there are often predators, irritating foods, emotional or excessive fatigue. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: peritonitis shock
Cause
Acute perforation of ulcer disease
Perforation of ulcer disease is the result of active ulceration gradually eroding deep into the serosal membrane. As a result of acute perforation of ulcer disease, about 70% have a long history of ulcer disease, and the symptoms of ulceration are often aggravated before perforation; about 10% The patient does not have a history of ulcers, but a perforation occurs suddenly. Before perforation, there are often predators, irritating foods, emotional or excessive fatigue.
Prevention
Acute perforation prevention of ulcer disease
Should pay attention to scientific diet, especially those with stomach problems, pay attention not to drink alcohol, so as not to aggravate the disease or cause disease, if sudden abdominal pain, should be sent to the hospital emergency as soon as possible, can not abuse painkillers before the diagnosis, fasting water prohibition hot, In order to avoid covering up and aggravating the disease, in addition, life should be regular, work and rest, avoid excessive tension and sorrow, etc. are important for patients with peptic ulcer.
Complication
Acute perforation complications of ulcer disease Complications peritonitis shock
After perforation, a large amount of gastrointestinal fluid flows into the abdominal cavity, causing chemical or bacterial peritonitis and toxic shock, etc., if not promptly rescued, it may be life-threatening.
Symptom
Acute perforation of ulcer disease Common symptoms Nausea abdominal distension Abdominal pain Fever shock Abdominal effusion Intestinal paralysis constipation Mobile dullness Peritonitis
The main symptoms and signs are as follows:
1. Abdominal pain: Sudden onset of severe abdominal pain is the most frequent and most important symptom of perforation. Pain initially begins in the upper abdomen or perforated area, often with knife-cutting or burning pain, generally persistent, but also has a sexual Aggravation, the pain spreads quickly to the entire abdomen and can be released to the shoulder for a stinging or sore feeling.
2. Shock symptoms: In the early stage of perforation, patients often have a certain degree of shock symptoms, and the disease progresses to bacterial peritonitis and intestinal paralysis. The patient may have toxic shock again.
3. Nausea, vomiting: About half of the patients have nausea, vomiting, not severe, vomiting worsens during intestinal paralysis, and there are symptoms such as bloating and constipation.
4. Other symptoms: fever, rapid pulse, increased white blood cells, etc., but generally appear several hours after perforation, a large amount of peritoneal exudation, when the peritoneal effusion exceeds 500 ml, can move out the mobile dullness.
Examine
Examination of acute perforation of ulcer disease
1. X-ray inspection.
2. Abdominal puncture to extract purulent fluid.
3. Referral.
Diagnosis
Diagnosis and diagnosis of acute perforation of ulcer disease
In a few cases, it is also necessary to distinguish from the following diseases.
1. When acute appendicitis ulcer disease is perforated, the contents can flow along the ascending colonic sulcus to the right lower abdomen, causing pain in the right lower quadrant, which may be confused with appendicitis, but the general symptoms of acute appendicitis are not as severe as perforation of ulcer disease, and most of the onset is Metastatic right lower quadrant pain can be aggravated by paroxysmal, without shock symptoms and no pneumoperitoneum.
2. The similarity of acute pancreatitis is sudden onset of severe pain in the upper abdomen, accompanied by vomiting and peritonitis. However, acute pancreatitis is painful in the left upper abdomen and can be released to the waist. Early peritoneal irritation is generally not obvious. There is a history of high-fat meal, no pneumoperitoneum at the time of examination, elevated serum amylase, and more than 85% of patients with acute pancreatitis can be found to have enlarged pancreatic enlargement.
3. Acute gallbladder patients with acute gallbladder, generally have a history of biliary tract disease, the pain is mostly confined to the right upper abdomen, to the right shoulder and back, the right upper abdomen can touch the enlarged gallbladder, ultrasound examination can be found in the gallbladder or gallbladder With stones, general identification is not difficult.
