What to Do If a Duodenal Ulcer Perforates

When a duodenal ulcer leads to a perforation, it can cause acute abdominal symptoms that require immediate medical attention. This is because the leakage of gastric contents into the abdominal cavity can trigger chemical peritonitis, a serious condition that needs urgent intervention.

Understanding Perforation Severity

Not all perforations are the same. In some cases, the hole may be very small—sometimes referred to as a "pinhole" perforation. In such situations, non-surgical or conservative treatment might be considered appropriate by a medical professional.

Non-Surgical Treatment Options

For minor perforations, treatment typically involves fasting to prevent further irritation of the abdominal cavity, along with intravenous antibiotics to prevent infection. Patients are also given medications to reduce gastric acid secretion, such as proton pump inhibitors (PPIs), to promote healing of the ulcer and prevent further complications.

When Surgery Is Necessary

If the perforation is large or if symptoms worsen despite initial conservative treatment, surgical intervention becomes necessary. Surgeons may opt for a simple repair of the perforation, especially in emergency situations. Alternatively, a more definitive procedure such as a partial gastrectomy or ulcer excision may be performed, depending on the patient's overall condition and the severity of the ulceration.

Importance of Close Monitoring

Regardless of the chosen treatment path, close monitoring is essential. Signs such as increasing abdominal pain, fever, or signs of sepsis indicate the need for immediate reassessment and possible surgical intervention.

Early diagnosis and appropriate management are key to a successful outcome in cases of duodenal ulcer perforation. Always seek prompt medical care if you suspect a perforated ulcer.