Damage to the mucous membranes of the stomach at its outlet or in the upper part of the body is called a peptic ulcer.
Without adequate timely treatment, the situation is aggravated. The defect, spreading to all layers of the body, provokes a rupture of the stomach ulcer,
, which is considered to be the severest complication of a gastroenterological disease, capable of ending for a patient with a lethal outcome.
If the stomach ulcer burst, only emergency surgery can help. With the refusal of surgical treatment, the patient is doomed. Conservative treatment in this case is ineffective.
What happens if the stomach ulcer burst, the first symptoms?
Perforation of the defect( rupture of the gastric wall) leads to the fact that the contents of the digestive organ, including gastric juices, pour into the peritoneum( a typical complication of ) or into the large / small omentum, gland bag, intercostal cavity, cellulose( retroperitoneal) - atypicalrupture of the ulcer.
After the ulcer has burst, an internal bleeding opens up in the abdominal cavity or in the gastrointestinal tract.
The physical, chemical and bacterial stimuli contained in food cause the strongest inflammatory process( peritonitis) developing in stages:
1 phase of peritonitis chemical( primary shock)
- May develop within six hours. The duration of the process depends on the diameter of the ruptured ulcer and the amount of food masses filling the organ;
- The fact that the ulcer has burst, will be reported by the intolerable "dagger pain" in the navel and epigastrium. If there was perforation of the anterior wall of the organ, pain sensations will be felt in the abdomen to the left, giving to the shoulder of the left hand;
- The position on the right side with the knees clamped for a short while relieves pain;
- Pale skin becomes sticky from cold sweat;
- Breath surface, chest, patient due to strained abdominal muscles can not take a deep breath;
- The indices of blood pressure are lowered, the pulse is normal, the facial features are sharpened, the eyes appear hollow;
2 phase of peritonitis bacterial( contamination by pathogenic microorganisms) is sometimes called the period of systemic inflammatory reaction and imaginary improvement. The stage is characterized by a reduction in the severity of symptoms. Often, patients who are in an uncritical state of euphoria, refuse to believe that the ulcer of the stomach has burst.
The pathogenic process is manifested:
- Rapid pulse, fever and lowering blood pressure;
- Intestinal peristalsis disappears, toxic paresis occurs( paralysis);
- The patient's tongue is dry, with a gray touch, spreading on the sides and at the top of the tongue.
- Abdominal muscles relax and take part in the process of breathing;
- If the rupture of the stomach ulcer is covered with a stuffing box, the pain disappears even when palpation;
It is at these two stages that operative medical care for erupting stomach ulcer will be effective. Otherwise, the complication will take a severe form of development, threatening the life of the patient.
Stage 3 - abdominal sepsis, diffuse purulent peritonitis.
At the end of twelve hours after the rupture, the patient's condition rapidly deteriorates:
- Permanent vomiting, leading to dehydration of the body;
- There are sharp temperature changes from 40 ° С to normal values of 36.6 ° С;
- The pulse is frequent( 120 beats per minute), the pressure drops below 100 mm Hg;
- Patient indifferent, sluggish, not reacting to external stimuli;
- The abdomen increases in volume due to the accumulation of fluid and gas;
- There is no urine release;
Surgical care at this stage rarely gives a positive result.
What the ulcer has burst from is the most common causes of
- Untimely diagnosis and inadequate treatment;
- Autumn-spring period;
- Psychotrauma stress situation;
- Aggravation of the disease with inflammatory process;
- Overfilling the stomach with food;
- High acidity;
- Inaccuracy in medical nutrition, alcohol and spicy food, hot and cold food, smoking;
- Large or sudden physical activity.