Gastric ulcer perforation clinical diagnosis and treatment of acute.docVIP

 PAGE \* MERGEFORMAT 5 Gastric ulcer perforation clinical diagnosis and treatment of acute Acute gastric ulcer perforation (acute perforation of gastroduodenal ulcer) is a common serious complication of gastric ulcer, the most common acute abdomen in clinical one. An etiology, pathology Perforated ulcer mostly occurs in the active stage of chronic, but acute ulcer perforation may also account for more than 20%. Perforations are located on the anterior wall of stomach and duodenum near the pylorus, especially in the anterior wall of duodenal ampulla smaller curvature for the most common. The vast majority of a single perforation. Of malignant transformation of gastric ulcer and gastric perforation of acute free perforation of cases the ratio of about 1% to 5%. Ulcer perforation immediately after the manifestations of acute diffuse peritonitis, initially chemical in nature, a few hours later developed into suppurative in nature. Clinical symptoms and signs of leakage into the abdominal cavity with the severity of gastrointestinal contents into the area. 2 Diagnosis 2.1 Clinical manifestations 2.1.180% ~ 90% of patients had a history of ulcers. Recent history of ulcer disease symptoms increased. 2.1.2 sudden abdominal pain, and soon spread to the whole abdomen. Often accompanied by nausea and vomiting. 2.1.3 often pale, cold sweats, cold extremities and other symptoms of shock. 2.1.4 All abdominal tenderness and rebound tenderness, abdominal and above the most obvious. Abdominal rigidity (plate-like belly). 2.1.5 abdominal breathing disappeared. Liver dullness sector shrink or disappear. Bowel sounds diminished or disappeared. Exudate reached more than 500ml may have a shifting dullness. 2.2 assistant examination 2.2.1 the total number of white blood cell count increased, the proportion of neutrophils increased. Serum amylase may be mildly elevated. 2.2.2 Perspective on the abdomen or flat standing position for about 80% of patients with unilateral