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Peptic Ulcer Perforation Surgery

Peptic ulcers are open sores that develop on the inner lining of the stomach, upper small intestine, or esophagus, usually due to the damaging effects of stomach acid. When left untreated, these ulcers can sometimes develop a perforation — meaning the ulcer breaks through the full thickness of the stomach or intestinal wall. This is a life-threatening medical emergency that requires immediate surgical intervention.
A peptic ulcer perforation occurs when an ulcer creates a hole in the stomach or intestinal wall, allowing digestive juices, food, and bacteria to leak into the abdominal cavity. This leads to a dangerous infection called peritonitis, which can cause widespread inflammation, sepsis, and can be fatal if not treated quickly. Perforation is one of the most severe complications of peptic ulcers, often arising from long-term Helicobacter pylori infection, excessive NSAID usage, smoking, or untreated ulcers.
Peptic Ulcer Perforation Surgery

Symptoms of Peptic Ulcer Perforation

The symptoms of a perforated ulcer are intense and unmistakable, requiring urgent medical care. Common signs include:

  • Sudden, severe abdominal pain (often starting in the upper abdomen and spreading)

  • Rigid or hard abdomen (muscle guarding)

  • Nausea and vomiting

  • Fever and chills

  • Inability to pass gas or stool

  • Rapid heartbeat and shallow breathing

  • Signs of shock (low blood pressure, confusion, cold and clammy skin)

Anyone experiencing these symptoms should seek emergency medical attention, as delay can lead to life-threatening complications.

Treatment: Peptic Ulcer Perforation Surgery

Once diagnosed, usually through physical examination, blood tests, and imaging like X-ray or CT scan, the patient will be prepared for surgery without delay.

Surgical repair involves:

  1. Emergency laparotomy (open surgery) or sometimes laparoscopic surgery (minimally invasive) to locate and repair the perforation.

  2. Cleaning and washing out the abdominal cavity to reduce infection risk.

  3. Closure of the ulcer with surgical stitches, sometimes reinforced with an omental patch (a piece of fatty tissue from the abdomen).

  4. Post-surgery, the patient will receive IV antibiotics, fluids, acid-suppressing medications (PPIs), and nutritional support until full recovery.

In most cases, surgery offers immediate relief from the life-threatening condition, but long-term management is needed to prevent recurrence.

Precautions & Prevention

Once the immediate threat is managed through surgery, the focus turns to preventing future ulcers. Essential precautions include:

  • Completing the full course of antibiotics (especially for Helicobacter pylori infection if present).

  • Long-term use of proton pump inhibitors (PPIs) or other acid reducers.

  • Avoiding NSAIDs, smoking, and alcohol.

  • Maintaining a bland, ulcer-friendly diet in the early recovery phase.

  • Regular follow-up with your gastroenterologist or surgeon to monitor healing and prevent recurrence.

Lifestyle modifications and medical compliance are critical to ensure long-term health and prevent a repeat emergency.