Possibility of perforation of the stomach if severe gastric ulcer is present

The article is professionally consulted by Doctor Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Peptic ulcer - duodenal ulcer accounts for about 26% and is having the highest incidence of diseases of the gastrointestinal tract. Chronic gastric ulcer not only reduces the quality of life but also causes dangerous complications such as: gastric bleeding, stomach cancer... Especially severe stomach ulcers can cause gastric perforation- a dangerous emergency complication.

1.1. pyloric stenosis Gastric stenosis is a very common complication in people with peptic ulcers. When having pyloric stenosis, the patient will feel extremely uncomfortable with the following symptoms:
Severe abdominal pain, intense, continuous and prolonged pain often appear or pain increases after eating. Nausea or vomiting. Vomited food has an unpleasant odor. People are tired, lethargic, sweaty, and have no energy 1.2. Stomach bleeding Stomach bleeding is a condition in which the stomach is bleeding, the cause of this condition is due to ulcers that damage blood vessels, when bleeding, the patient may vomit blood or black fluid Black feces like tar or coffee powder, with a stench like the smell of decaying animal carcasses.
1.3. Stomach cancer The symptoms of stomach cancer are often very vague. Common symptoms are dull pain, bloating, indigestion, belching, nausea and loss of appetite. These symptoms are easy to ignore, so the disease is difficult to detect in time. When the above symptoms persist for more than 2 weeks, the patient should seek medical attention. Some other signs of the disease may be: vomiting, weight loss, anemia, abdominal pain, fatigue, black stools.

Many patients with chronic peptic ulcer disease may not present with symptoms such as abdominal pain or vague pain. The cause is due to many other diseases that can cause epigastric pain such as appendicitis, pancreatitis, spondylitis...
Cases of sudden gastric perforation without prompt emergency treatment can quickly lead to peritonitis and is very likely to die.
If gastric ulcer is not treated early or is not treated completely, it can cause gastric perforation. Manifestations of gastric perforation are very intense.
The pain in the epigastrium, the stomach is very strong, it feels like there is a knife in the abdomen, no matter what it is, it can't ease the pain. The abdomen is tight, just breathing hard also causes more pain. From the epigastric region, the pain will spread throughout the abdomen, up to the chest, shoulders, and back. Feeling of no strength, fatigue, pale face, cold hands and feet, sweating, possibly low blood pressure. When a person with a stomach ulcer has the above symptoms, it can be confirmed that 90% of the disease has a complication of gastric perforation. The longer it goes on, the more life-threatening it will be.

Chronic gastritis will be more dangerous and can cause gastric perforation complications for groups of people such as:
Regular smokers Regularly using anti-inflammatory drugs Have a history of stomach ulcers Over 50 years old use stimulants such as alcohol, beer... People with anemia

Principles of treatment of gastric perforation Surgery should be performed as soon as possible. when severe peptic ulcer progresses to gastric perforation, you will be operated on 12 hours before, the mortality rate is 0-0.5%; after 12 hours mortality to 15%. Therefore, the entire hospital team must quickly prepare to be able to immediately handle this urgent case.
Enduring treatment In the process of waiting for intensive methods, this temporary method can be applied to ensure the patient's life. Aspiration by nasogastric tube and intravenous infusion with high-dose antibiotics to prevent infection.
Treatment of perforation How surgically sutured the perforation depends on the nature of the perforation. With young punctures, the procedure is very easy. If the puncture is long, hard, it requires a more careful suturing technique. The needle should be placed on the softener distal to the callus, or cut off the callus and suture in 2 layers with the outer layer using linen thread and the inner layer using catgut thread.
Partial gastrectomy If the stomach is perforated due to cancer, pyloric stenosis or the perforation is too severe to be sutured, part of the stomach must be removed. Part of the stomach will be removed laparoscopically, but it carries many dangerous risks.
In some cases, the patient after surgery to remove part of the stomach will have to have an appropriate diet:
+ Keep the body hydrated: drink ordinary water, can drink fruit juice, tea.
+ Food should be cooked foods, easy to digest, limit foods high in fiber. When the wound has shown signs of healing, the patient can eat meat, eggs or bread.
Prevention of stomach ulcers Create good living habits such as exercise, reduce stress, anxiety Eat and sleep properly Avoid processed foods, foods high in sour and spicy substances and avoid smoke cigarette. It should be noted that pain is a warning signal from the body that something unusual is going on. Therefore, absolutely should not be subjective, it is necessary to go to the hospital for early examination to be checked in time, to avoid falling into a dangerous situation.
Visiting the doctor as soon as there are abnormal signs, periodic health check-up, detecting and treating stomach ulcers early is a good way to help protect the health of yourself and your family members.
Vinmec International General Hospital currently has general health checkup packages, performed by a team of experienced doctors and nurses with the support of modern technological equipment, which will detect the earliest signs of symptoms. symptoms of gastric ulcer disease, on that basis, propose the most optimal treatment regimen.