Perforated ulcer
A perforated ulcer is a condition in which an untreated ulcer has burned through the mucosal wall in a segment of the gastrointestinal tract allowing gastric contents to leak into the abdominal cavity.
Signs and symptoms
A perforated ulcer can be grouped into a stercoral perforation, which involves a number of different things that cause perforation of the intestine wall.The first symptom of a perforated peptic ulcer is usually sudden, severe, sharp pain in the abdomen. The pain is typically at its maximum immediately and persists. It is characteristically made worse by any movement, and greatly intensifies with coughing or sneezing.
Causes
Causes include alcohol, smoking, consuming highly acidic foods and beverages, and nonsteroidal anti-inflammatory drugs.Diagnosis
The ulcer is known initially as a peptic ulcer before the ulcer burns through the full thickness of the stomach or duodenal wall. A diagnosis is made by taking an erect abdominal/chest X-ray. This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer. Many perforated ulcers have been attributed to the bacterium Helicobacter pylori.Treatment
Treatment generally requires immediate surgery.Prognosis
Perforated peptic ulcer is a serious condition with an overall reported mortality of 5%–25%, rising to as high as 50% with age. The incidence of perforated ulcer is steadily declining, though there are still incidents where it occurs.Notable cases
1892 saw the first time anyone survived surgery for a perforated peptic ulcer.- Richard Pankhurst had a perforated ulcer and died on 5 July 1897.
- Thomas Preston had a perforated ulcer and died in 1900.
- Rudolph Valentino had a perforated ulcer and died on August 23, 1926.
- Rudyard Kipling died of perforated duodenal ulcer on 18 January 1936.
- James Joyce had a perforated ulcer and died on January 13, 1941, in Zürich.
- Guy Rochon Owen had a perforated ulcer, and died on April 21, 1952.
- Charlie Parker had a perforated ulcer, and died on March 12, 1955.
- Albert Blithe had a perforated ulcer and died on December 17, 1967.
- Pavel Belyayev had a perforated duodenal ulcer that progressed to peritonitis following surgical complications, and died on January 10, 1970.
- Gene Vincent had a ruptured stomach ulcer and died on October 12, 1971.
- J. R. R. Tolkien had a perforated ulcer and died on September 2, 1973.
- Count Dante died of internal hemorrhaging caused by a bleeding ulcer, on May 25, 1975.
- Ian Hendry died of a stomach haemorrhage in London.
- Gene Clark had perforated ulcer and died on May 24, 1991.
- Doug Hepburn had a perforated ulcer and died on November 22, 2000.
- Philip Agee had a perforated ulcer and died on January 7, 2008.
- Barbara Bush was treated for a perforated ulcer in November 2008.
- Tara Palmer-Tomkinson had a perforated ulcer and died on February 8, 2017.
- Steve Wright died from a stomach ulcer rupture on 12 February 2024.