Acute Perforation of Gastric and Duodenal Ulcers: Clinical Characteristics and Management

Acute perforation of gastric and duodenal ulcers is a serious medical condition characterized by a sudden onset and rapid progression. Patients often have a history of peptic ulcer disease or other underlying gastric conditions. Factors such as overeating, excessive physical exertion, lack of sleep, or a weakened immune system can trigger a sudden, severe abdominal pain that quickly spreads throughout the entire abdomen.

Common Clinical Symptoms

One of the most notable signs is the rapid development of generalized peritonitis within a short time after the perforation occurs. This leads to widespread abdominal tenderness, muscular rigidity, and rebound tenderness — all classic indicators of peritoneal irritation. The intensity of pain and the speed at which symptoms escalate make this condition a medical emergency.

Potential Complications

Systemic Effects

In addition to severe abdominal pain, patients may experience intense nausea, vomiting, fever, and in more severe cases, signs of septic shock. These symptoms indicate a systemic inflammatory response due to bacterial contamination of the peritoneal cavity. If not addressed promptly, this can lead to life-threatening complications such as multi-organ failure.

Emergency Treatment and Surgical Intervention

When symptoms of acute perforation appear, immediate medical attention is crucial. Patients should seek emergency care as soon as possible. Initial treatment typically involves aggressive fluid resuscitation, administration of broad-spectrum antibiotics, and early surgical intervention such as exploratory laparotomy. The surgical approach and specific procedures are determined based on intraoperative findings and the patient's overall condition.