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Perforated ulcer of the stomach and duodenum

There are perforations of chronic and acute ulcers. By localization, gastric ulcers (lesser curvature, anterior and posterior walls, cardiac, pyloric) and duodenal ulcer (bulbar, postbulbar) are found. Perforation can be typical - in the free abdominal cavity or atypical - covered, in an omental bursa, in retroperitoneal fiber.

D - ka:

There are 3 stages during a perforated ulcer.

The stage of shock (first bh) is characterized by sharp pain in the epigastric region, which suddenly appeared as a “dagger strike”. Possible vomiting. Pallor of the skin with slight cyanosis of the lips is noted. Cold sweat. The breath is shallow. Bradycardia, blood pressure reduced. The body temperature is normal. The abdomen is not involved in breathing, retracted. Palpation and percussion of the abdomen are sharply painful. On palpation - expressed muscle tension (abdomen "like a board").
Symptom Shchetkina - Blumberg positive. With percussion, the disappearance of hepatic dullness may be noted.

The stage of imaginary well-being (after 6 hours) is characterized by a decrease in abdominal pain, but symptoms of peritonitis and general intoxication increase: tachycardia, fever, dry tongue, increasing bloating, delayed stool and gas due to intestinal paresis. Percussion - gas and the presence of fluid in the upper sections and in the flat areas of the abdomen, peristalsis is sluggish. Symptom Shchetkina - Blumberg positive.

The stage of peritonitis (develops after 10-12 hours from the onset of the disease). Abdominal pains intensify, a feeling of bloating, gas exhaustion, the body temperature rises, tachycardia increases. Symptoms of peritoneal irritation are sharply positive. Peristaltic noises are either attenuated or absent.
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Perforated ulcer of the stomach and duodenum

  1. Perforated ulcer of the stomach and duodenum
    Perforated (perforated) ulcer of the stomach or duodenum - the formation of an opening in the wall of the stomach or duodenum in a pre-existing ulcerative defect and the entry of gastrointestinal contents into the abdominal cavity. ETIOLOGY AND PATHOGENESIS A perforated ulcer is preceded by an exacerbation of a peptic ulcer or the development of an acute ulcer. Perforations contribute to: ¦ alcohol intake; ¦
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  3. Perforated ulcer of the stomach and duodenum
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