Gastric perforation or perforated stomach is a condition in which the stomach wall has a hole, which may be caused by a stomach ulcer or other causes such as a physical accident. This disease often occurs together with peritonitis when bacteria, food particles or stomach acid come into contact with the peritoneal cavity, which can cause severe stomach pain and a risk of bloodstream infection or death. Therefore, patients must see a doctor immediately if they have symptoms of a perforated stomach and often require surgical treatment.
Symptoms of gastric perforation
Patients often present with symptoms that occur with peritonitis, including:
- Severe abdominal pain, especially when touched or felt, with the patient often having a swollen abdomen and feeling harder than usual, which improves when lying still.
- Nausea, vomiting
- Fever, chills, fatigue
- Less urination, defecating, or farting than usual
- Rapid heartbeat, shortness of breath
Causes of gastric perforation
If it is a spontaneous stomach perforation, the exact cause is still unknown in medicine. However, there are risk factors that may cause a stomach perforation, including:
- stress
- Drinking alcohol or smoking
- Use of drugs such as cocaine or amphetamines
- pylori bacterial infection
- Use of certain medications, such as NSAIDs suchas aspirin, ibuprofen, naproxen, steroids, and some chemotherapy drugs.
- Certain medical conditions, such as stomach cancer and Zollinger -Ellison Syndrome, which cause excessive stomach acid secretion, are rare.
- Gastric bypass surgery for obesity
- Physical accidents such as knife or bullet penetration into the stomach, swallowing objects such as toys, stationery, etc.
- Gastroscopy can also cause stomach perforation, although this is very rare.
Diagnosis of gastric perforation
Doctors usually diagnose gastric perforation by taking a history and examining the patient’s symptoms. In addition, doctors may perform blood tests and X-rays to diagnose symptoms, find the cause of the disease, and check for other complications, especially bloodstream infections. The details are as follows:
- To check the amount of minerals and pH in the blood, including liver and kidney function, to aid in diagnosis.
- Check the red blood cell count, which may decrease if blood is lost, and the white blood cell count, which may increase if infection occurs.
- X-rays of the upper gastrointestinal tract, chest, and torso are used to diagnose air in the abdominal cavity and determine if there is a perforation of the gastrointestinal organs.
- A CT scan of the abdomen to identify the location of the stomach perforation.
Treatment of gastric perforation
Gastric perforation must be treated at the cause. Treatment options include gastric ulcer treatment, surgery, and peritonitis treatment. Treatment options include:
Treatment of gastric ulcers: Patients with gastric ulcers may need to take medications as prescribed by their doctor, such as antacids, stomach lining coating agents, antibiotics to kill H. pylori bacteria, proton pump inhibitors, and H2 blockers, which help block the production of stomach acid and treat gastric ulcers.
Surgery: Most patients require emergency surgery if the stomach is perforated to close the wound and remove bacteria, food debris, and acid from the peritoneal cavity. The effectiveness of treatment depends on the cause of the perforation, the size of the wound, the stage of the disease at the time of treatment, and other factors that may delay healing or increase the risk of complications, as follows:
- Old age, malnutrition, smoking, drinking alcohol, and lack of good hygiene
- Obese or have underlying diseases such as diabetes, heart disease, kidney disease, liver disease, and emphysema.
- Use certain medications or addictive substances, such as steroids or corticosteroids, which suppress the immune system; use medications to treat Crohn’s disease, lupus, colitis, and arthritis; or use medications to treat cancer.
- Bleeding, blood clots, or kidney failure
Treatment of peritonitis: Since patients often have perforated stomach along with peritonitis, they must receive intravenous antibiotics. Patients with organ failure from bloodstream infection must receive fluids, blood pressure medication, and nutrients along with intravenous antibiotics. Patients must be hospitalized and monitored for bloodstream infection or septic shock.
Complications of gastric perforation
Possible complications from a perforated stomach include bleeding, infection in the abdominal cavity, abscess formation, and septicemia, which can lead to death.
Prevention of gastric perforation
Gastric perforation is a condition that can occur from many causes, so there is no direct way to prevent it. However, there are ways to reduce the risk of gastric perforation as follows:
- Know how to deal with stress
- Do not use any drugs.
- Avoid or reduce alcohol consumption. You should not drinkmore than 1-2 standard drinks per day.
- No smoking
- Do not take NSAIDs for a long time. Always consult your doctor if you need to take them, such as taking aspirin to treat heart disease.
- Patients with chronic diseases should see a doctor regularly to monitor the results of their treatment. If they have symptoms of a perforated stomach, especially stomach pain and fever, they should see a doctor immediately.
