A perforated ulcer is a condition in which an untreated ulcer can burn through the wall of the stomach (or other areas of the gastrointestinal tract), allowing digestive juices and food to leak into the abdominal cavity. Treatment generally requires immediate surgery.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 . This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer. Many perforated ulcers have been attributed to the bacterium Helicobacter pylori.The incidence of perforated ulcer is steadily declining, though there are still incidents where it occurs.Causes include smoking and nonsteroidal anti-inflammatory drugs (NSAIDs).
A perforated ulcer can be grouped into a stercoral perforation which involves a number of different things that causes perforation of the intestine wall. The first symptom of a perforated peptic ulcer is usually sudden, severe, sharp pain in the abdomen. The experience is typically so intense that most people precisely recall the exact moment the pain began. 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.
- 50 years ago perforated peptic was a disease of young men
- Today it is a problem seen mainly in elderly women
- Overall incidence for admission with peptic ulceration is falling
- The number of perforated ulcers remains unchanged
- Sustained incidence possibly due to increased NSAID in elderly
- 80% of perforated duodenal ulcers are H.pylori positive
A peptic ulcer is a type of sore that develops in the digestive system.The word “ulcer” means open sore, and “peptic” means that acid is the cause of the sore.However, this terminology is from a prior era when all ulcers in the esophagus, stomach, and duodenum were thought to be caused by acid damage.Nowadays, we know that most ulcers are not caused by excessive acid, so the term “peptic ulcer” is somewhat misleading.
The most common kinds of peptic ulcers are:
Gastric ulcers: A common type of ulcer, these occur on the inside of the stomach.
Duodenal ulcers: These are located at the beginning of the small intestine (called the small bowel or duodenum).
Esophageal ulcers: These occur inside the esophagus (the tube that carries food from your throat to your stomach).