Is perforation of an empty organ dangerous?

The article is professionally consulted by Master, Doctor Vu Huy Binh - Digestive Endoscopy Doctor - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital

Hollow visceral perforation is a dangerous surgical emergency with a high mortality rate, requiring early emergency surgery. Many people are subjective with abdominal pain after eating, chronic stomach pain ... leading to a critical condition.

1. Causes of perforation of hollow organs

Perforation peptic ulcer accounts for 90%. Closed abdominal trauma: + Intestinal perforation: the most common is the duodenum, followed by the jejunum, and the least common is the colon.
+ Bladder rupture: may occur pneumoperitoneum.
Injury penetrating the abdominal wall . Perforation of hollow organs due to swallowing or falling foreign objects.
Perforation due to insertion of a foreign body into the rectum and vagina.
Necrotizing gastrointestinal tract leading to perforation of hollow viscera :
Necrotizing enterocolitis Inflammatory bowel disease in typhoid Necrotizing appendicitis Diverticulitis colonic perforation of the uterus due to abortion abortion Perforation due to gastrointestinal endoscope

2. Risk factors

Perforation of hollow viscera is more common in men aged 35 - 65 years, but most often in the age group of 30 - 40 years old, but there are also many patients over 80 - 85 years old. The predisposing factor for the disease is cold weather.

3. Symptoms of hollow visceral perforation

The patient feels sudden, severe pain as the main sign. Vomiting is present but is uncommon. In the first few hours there is no bowel movement.
When the patient's pain is severe and increasing, the doctor finds that the abdomen is as hard as wood, and the abdominal wall spasticity (of varying degrees) is an ever-present symptom of a perforated hollow viscera.

Đau bụng là triệu chứng ban đầu của thủng tạng rỗng

The above symptoms are different from cases of peritonitis due to other causes. However, the clinical course can change to another form that is: in the first 6 hours, the patient has severe epigastric pain, often accompanied by shock, the pain quickly spreads throughout the abdomen and changes to the normal stage. (about the next 6 hours) especially in the case of small perforation, far from the meal, or the hole is closed, gastric juice escapes through the small hole and may flow down the right iliac fossa along the right colonic groove, causing pain in the right iliac fossa, so it is easily confused with acute appendicitis.

4. Diagnosis of hollow visceral perforation

It is necessary to promptly take the patient with a perforated hollow organ to the nearest medical center for emergency medical care and treatment. The following techniques can be used to determine where and to what extent the hollow visceral perforation is:
Unprepared standing abdominal X-ray shows the patient's crescent below the diaphragm. Ultrasound of patients with perforated hollow viscera shows free air and fluid in the peritoneal cavity.

Thủng tạng rỗng được chẩn đoán bằng kỹ thuật siêu âm

5. Treatment of hollow organ perforation

Previously, to treat the disease, there was only one way to open the abdomen to find and sew up the perforation. Perforation of hollow organs is dangerous to the patient's life. This is a major surgery, so after surgery, the patient takes a long time to recover as usual. However, thanks to technological advances, especially since laparoscopic surgery, the treatment of perforated hollow viscera has become easier. Laparoscopic surgery has many advantages over traditional surgery: small incisions, less invasive, less impact on other organs in the abdomen, so it will help the patient's recovery process after surgery. occur faster, with fewer infections, and sooner patients are discharged from the hospital.

6. Prevention of hollow organ perforation

Doctors recommend that people should not be subjective with their own health, should go to the doctor soon if they see signs of peptic ulcer with symptoms such as: burning in the epigastrium, belching, heartburn, ... for timely treatment advice, avoid dangerous complications such as ulcer perforation, stomach bleeding, cancer ...

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