creation and production of high-power active anti-ulcer drugs greatly facilitated struggle with stomach ulcers.Such patients are less likely to be seen in hospital beds in the departments of therapeutic profile.However, both acute and chronic gastric ulcer, especially complications thereof, may still be a serious cause of surgical intervention.One of the most painful complications such ulcers is their perforation or perforation. Content
Despite all the achievements of the last decades in the treatment of peptic ulcer disease, the frequency of perforated ulcersIt reaches 10%.They account for a quarter of ulcer complications and symptomatic ulcers.Most often it occurs in men.And the terrible state may end not only the operation but also fatal.
perforation of the stomach and can cause chronic and acute ulcers.The first is a direct complication of the "classical" peptic ulcer (80% perforation).The second group of ulcers is the result
When perforation ulceration (destruction) are subjected to all four layers of the stomach wall: mucosal, submucosal, muscular, visceral.Because of this, there is formed an opening through which the contents of the chemically aggressive with hydrochloric acid and gastric enzymes penetrates into the abdominal cavity and provokes inflammation of the peritoneum.
On the causes of stomach ulcers says Elena Malysheva and her colleagues:
In some cases, the symptoms of perforated ulcer is difficult to confuse with other diseases, so it is bright.But there are more sophisticated options.Thus, the clinical course of the perforations may be:
In a typical embodiment, the development of perforated ulcer can be divided into three periods, characterized by clinical manifestations.Harbingers of perforation may be:
Then there is a sudden change in the pattern of the disease.The patient appears:
peritonitis (usually 6 - 8 hours after the perforation) is accompanied by further deterioration.The pulse becomes thready patient, fever, symptoms, characteristic of intestinal obstruction.In the absence of surgical care of the patient's sad fate sealed.
atypical course of perforated ulcers characterized by increased pain, a change in their nature (is lost chronological relationship with food, the pain becomes constant) and / or localization.From the epigastric area pain moved to the back, right upper quadrant or in the chuck area.Such perforated ulcer is much more difficult to recognize.Sometimes, after enduring a cover perforated holes there is a significant improvement.But in the future the majority of patients the fabric covering the perforations are broken, and developing peritonitis.
Even an inexperienced specialist may be suspected perforated gastric ulcer typical at the mere sight of the patient.In order to somehow reduce the unbearable pain, so the patient is forced to urge the legs.He is pale, covered with cold sweat.The patient can not breathe freely without the pain completely.Stomach in, is not involved in breathing.When the feeling of muscle tension, he recalls a solid board.While rapping disappear or reduced hepatic dullness area (this phenomenon is due to penetrated into the abdominal cavity with air).
But the final verdict of the diagnostic can be taken only after a tool inspection.Detection of perforation of ulcer help:
Unfortunately, no pills and injections are not yet able to fix a defect is generated in the gastric wall.The only treatment perforated ulcer - surgery.Depending on the clinical circumstances, surgeons make:
In recent years, doctors try not to cut the abdominal wall, and the resort to laparoscopic surgery.It eliminates a large surgical wound, as for all the manipulations enough 4 punctures.Through these special tools and endoscopic instrument is introduced into the abdominal cavity, and then perform the desired surgical effects.Laparoscopic surgery provides better tolerated by patients and more rapid postoperative rehabilitation.
Foreign experts have developed a more sparing surgery technology, eliminating the need for damage to the abdominal wall.Surgical Instruments plant through a special fibrogastroscopy, and then through a puncture in the wall of the stomach.
In the popular television program tells how to protect your stomach from ulcers: