Perforation of gastric – duodenal ulcer: Dangerous complications of peptic ulcer – duodenal ulcer

The article is consulted professionally by Specialist Doctor II Hoang Thi Hien – Endi digester, Department of Medical Examination and Internal Medicine – Share99 Hai Phong International Health Hub.

Peptic ulcer disease is a disease caused by an imbalance between the attacking factor and the protective factor of the gastrointestinal mucosa. Diseases that are not properly detected and treated can turn into dangerous complications.

Peptic ulcer disease if not detected and treated early can progress and cause life-threatening complications such as:

• Gastrointestinal bleeding: Hemorrhages or bleeding ulcers often occur, may occur suddenly or after the patient uses substances that irritate the gastrointestinal mucosa such as drinking alcohol, using anti-inflammatory drugs … with the manifestation of vomiting fresh blood, going outside black stools, blood pressure drops …
• Perforation of the stomach – Duodenum: The patient appears severe abdominal pain, pain such as a knife, a hard belly like wood, accompanied by vomiting, sweating, cold limbs.
• Permanitis: Peptic ulcer is the cause of permanitis, with manifestations such as eating slowly, bunging pain, vomiting food from the previous meal….
• Cancer: Stomach ulcers can lead to stomach cancer, regularly visiting to detect early the progressive condition of the disease.

Perforation of the ulcer is a serious and severe complications of peptic ulcer disease. If not diagnosed early and handled in a timely manner this complications will be life-threatening.

• Can be seen at any age, most commonly at working age.
• More common in men than women, it may be due to a diet that drinks a lot of alcohol, smokes.

• Clinical signs:

Sudden severe pain in the endo bay area, constant pain, making the patient dare not breathe strongly. The patient's abdomen becomes as hard as wood. Hours later, if the patient is still not treated, the pain spreads throughout the abdomen.

Due to the spillage of the peritoneal cavity, patients with signs of shock such as rapid pulse, blood pressure drops, sweating, pale face, shallow rapid breathing, a few hours after the signs of shock gradually decrease the patient may see an increase in temperature due to peritonitis.

• Sublinical:

X-rays showed signs of sickle under the diaphragm. However, in cases of small holes, the puncture has not seen the image of sickle vapor under the diaphragm.

Increasing the incidence of sickle on X-rays can carry out inflatables through gastric sonde, the simple procedure is quite safe, making the diagnosis more accurate

If X-rays are not visible, laparoscopy can be used for diagnosis and treatment.

On the background of a patient with a history of peptic ulcer, the appearance of the above clinical and subclinical signs needs to be diagnosed and treated urgently. As a surgical emergency, there is no conservative treatment, treatment is required.

Surgery must be carried out as soon as possible. If the patient is operated before 12h the mortality rate is about 0-0.5%, after 12h is 15%, and if it is later than 24 hours in frail elderly patients, the mortality rate is up to 30%.

Duodenal ulcer disease is perfectly treatable with drugs in combination with a reasonable diet. Early treatment of the disease to avoid unfortunate complications that endanger the health and life of the patient

When there are signs of illness, patients go to medical facilities to examine and determine the cause of the disease. Do not use the drug without the guidance of medical staff.

The drugs used include:

• Hp antimicrobial antibiotics follow the health department's regimen when HP is positive.
• The drug neutrals a translated acid.
• A decrease in aerated acid secretion: Inhibits H2 receptors or proton pump inhibitors.

In addition to adhering to the use of the drug, changing the diet and activities helps to improve the disease.

• Follow a healthy diet: Eat in mode order without giving up meals, do not overeating, do not leave your stomach too hungry, break down meals.
• Do not use drinks with gastric stimulant properties such as alcohol, beer, coffee, gas drinks …
• Do not eat sour, spicy foods
• Eat fruits, greens and whole grains
• Avoid staying up late, getting enough sleep.

• Do not exercise, exercise a lot after eating. Rest after eating for at least 30 minutes.
• Regular exercise avoids stress, reduces anxiety, helps mental comfort.
• Eat easily digested, soft food, avoid too hard food.

After treatment, the patient should be re-examined, to assess the condition. Regular check-up to detect abnormal changes in the disease or recurrence of the disease.

Peptic ulcer disease seems simple but can cause life-threatening complications. Perforation of the gastric-duodenal ulcer is a very dangerous complications of the disease, a high mortality rate if detected and treated late. Avoid ermful complications as soon as there are symptoms that patients should go to the doctor to detect and treat the disease early.

Dr. Hoang Thi Hien has 24 years of experience in the field of digestion, especially with strengths in: Diagnostic examination and treatment of digestive diseases, digestive endoscopy.

Dr. Hien has participated in many scientific seminars, short-term training courses on domestic and international digestion and is a member of the Vietnam Association of Digestive Endoscopy Associations. In the process of work, the doctor was former head of the department of internal medicine at Viet Tiep Health Hub before being a doctor of general internal medicine at Share99 Hai Phong International Health Hub.

Share99 International Health Hub is one of the leading hospitals in the country in terms of examination, diagnosis and treatment of digestive diseases.