Perforated ulcer
Medical condition From Wikipedia, the free encyclopedia
Medical condition From Wikipedia, the free encyclopedia
A perforated ulcer is a condition in which an untreated ulcer has burned through the mucosal wall in a segment of the gastrointestinal tract (e.g., the stomach or colon) allowing gastric contents to leak into the abdominal cavity.
| Perforated ulcer | |
|---|---|
| Other names | Ruptured ulcer |
| |
| Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper gastrointestinal hemorrhage and could potentially lead to perforation. | |
| Specialty | Gastroenterology  |
| Symptoms | Abdominal pain, vomiting, nausea |
| Complications | Bowel perforation, sepsis, gastrointestinal hemorrhage |
| Usual onset | Sudden |
| Risk factors | Untreated peptic ulcer |
| Treatment | Immediate surgery |
A perforated ulcer can be grouped into a stercoral perforation which involves a number of different things that cause perforation of the intestine wall. The first symptom of a perforated peptic ulcer is usually sudden, severe, sharp pain in the abdomen.[1] The pain is typically at its maximum immediately and persists. It is characteristically made worse by any movement, and greatly intensifies with coughing or sneezing.[citation needed]
Causes include alcohol, smoking, consuming highly acidic foods and beverages (such as coffee), and nonsteroidal anti-inflammatory drugs (NSAIDs).[2]
The ulcer is known initially as a peptic ulcer before the ulcer burns through the full thickness of the stomach or duodenal wall. A diagnosis is made by taking an erect abdominal/chest X-ray (seeking air under the diaphragm). This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer.[3] Many perforated ulcers have been attributed to the bacterium Helicobacter pylori.[4]
Treatment generally requires immediate surgery.[5]
Perforated peptic ulcer is a serious condition with an overall reported mortality of 5%–25%, rising to as high as 50% with age.[6] The incidence of perforated ulcer is steadily declining, though there are still incidents where it occurs.[2]
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