PERFORATED PEPTIC ULCER: GASTROINTESTINAL EMERGENCY

Having sudden onset of unbearable sharp, intense abdominal pain and a little movement is making it even more worse! And your patient have a history of acidity or ulcer! It’s an alarming situation that your patient may need an emergency consultation. It may be perforated peptic ulcer. PPU is an emergency as it lead to infection of peritoneum by leaked gastric contents. These gastric content must be sucked out by laparoscopic suction irrigation pump.

How you define perforated peptic ulcer?

Peptic ulcer is a sore or wound on the inner lining of lower most part of stomach. If it gets deep in stomach wall making a hole through it. Then it is called perforation peptic ulcer. This is a medical emergency. It can be either in stomach or duodenum.

How perforation peptic ulcer presented with?

Symptom:

a) severe pain, patient takes fetal position.

b) vomiting before starting pain.

c) feeble rapid pulse

d) cold clammy skin

e) fever

How perforated peptic ulcer happens in GI tract?

Stomach and duodenum have their own protective lining. It protects their inner lining from strong stomach acid. When the inner lining get eroded then following problem occur:

Gastritis(inflamed stomach tissue)

An ulcer(sore or wound)

Normally,peptic ulcers is caused by infection of H pylori(Helicobacter pylori). These bacteria live in the gut of people with ulcers.

Who are prone to develop PERFORATED Peptic ULCER?

“HURRY, WORRY AND CURRY”.

Bad eating habits always put in danger of developing ulcer:

Drinking too much alcohol.
Continuous use of NSAIDS,aspirin (which increases risk of bleeding).
Use of carbonated drinks.
Being on some treatments like radiation therapy, breathing machines or ulcerogenic medicines.
Stress.
Irregular timing of meals
Some medical conditions.
Trauma

How you will know it’s perforated peptic ulcer?

Prompt investigation and diagnosis can result in good outcome of treatment. Mainly, it’s diagnosis depends on following:

History from patient- complain of recurrent epigastric pain. Patient may give history of untreated corrosive ulcer or ongoing symptoms and sudden increase of pain or any recent instrumentation.

Physical examination- it shows rebound tenderness of abdomen, broad like abdomen. Fetal position of victim.

Blood investigation for serum amylase lipase, for infection etc.

Chest x-ray — it shows presence of air below the diaphragm. If history is appropriate and symptoms is exactly like PPU then chest x- Ray can justify the diagnosis. Barium meal can be done to see the pathway.

CT scan abdomen — it increases the ability of diagnosis if it is contrast CT scan.

How Perforated peptic ulcer is treated?

Overlooking the symptoms and delay in seeking medical help can be fatal.

1) MEDICAL INTERVENTION

if the diagnosis is confirmed for perforated peptic ulcer the resuscitation process to be started aggressively, stomach decompress by nasogastric suction, and broad spectrum antibiotic is started. H- pylori treatment kit can be used.

Symptomatic treatment is also started as if there is pneumoperitoneum then suction is done to relieve the tension in peritoneum, fluid maintenance etc. Ulcer has self sealing property and peritonitis may recover in 4–6 hours. If it is not solved with medication then surgical intervention is needed. As there may be leakage of gastric content or blood in peritoneum which has to be sucked out by laparoscopic irrigation pump.

2) SURGICAL INTERVENTION

Surgical option is used for PPU not responding to medical treatment and it is worsening by bleeding. The management of PPU is immediate surgery and the laparoscopy surgery has improved its treatment. Laparoscopic surgery shows good results in PPU repair.

Moreover, laparoscopic repair of PPU is done after visualizing the correct site of perforation, the leaked gastric content can be washed by irrigation pump and aspirated out by laparoscopic irrigation pump.

Small incision on abdomen made by surgeon to put laparoscopy with camera and LED light. To make more space inside co2 insufflator is used. With the help of other port and instrument surgeon repairs hole with patch.

Laparoscopy is more feaseble and easily improvable as compared to conservative open surgery.

We are here to deal with your problem by our highly equipped laparoscopy. It is equipped with irrigation pump, laparoscopic suction irrigation pump, co2 insufflator, LED light etc.

To get more info please contact us on http://www.diasurge.com/