Peptic Ulcer Perforation: What You Need to Know

Peptic ulcer perforation is a serious medical condition that requires prompt attention. When a peptic ulcer in the duodenum or stomach creates a hole or perforation, immediate medical care is essential. In cases of fasting duodenal ulcers with perforation, conservative management may be an option. This typically includes fasting, gastric decompression through a nasogastric tube, administration of antibiotics to prevent infection, intravenous fluids and blood transfusions if necessary, and the use of medications like somatostatin analogs to reduce gastric secretions.

When Surgery Is Necessary

If conservative treatment fails to improve the condition, emergency surgery becomes necessary. Patients who experience a perforated peptic ulcer after eating should undergo urgent surgical intervention. The most common procedure is simple closure with sutures, especially for benign ulcers. This approach is often effective and can prevent further complications.

Advanced Treatment Options

For patients whose symptoms have been present for a short duration and who show minimal signs of peritoneal contamination, a partial gastrectomy may be considered as an alternative. This procedure involves removing the affected portion of the stomach and is often performed using minimally invasive techniques such as laparoscopic surgery. Laparoscopic procedures are preferred due to their reduced recovery time and lower risk of postoperative complications.

Post-Operative Care and Medication

Following surgical repair, especially after a suture-based procedure, it is crucial to undergo a full course of anti-ulcer therapy. This usually includes proton pump inhibitors (PPIs) to reduce stomach acid and antibiotics if Helicobacter pylori infection is present. Proper follow-up care and adherence to prescribed medications significantly reduce the risk of recurrence and promote long-term gastrointestinal health.