Tokushukai Medical Group

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Digestive System Surgery: Gastroduodenal Perforation

Gastroduodenal Perforation is a disease, which sudden stomach pain comes up when it is developed, and in case if it is left untreated, it may risk the life.
But it can be aborted with early check-up and exams.

Inflammation advance in stomach or duodenum.

Almost all the cause for Gastroduodenal Perforation is gastric and duodenal ulcer. Occasionally, it may be perforated by stomach cancer.

Almost all the causes for gastric and duodenal ulcer is the pylori infection. Antipyretic Analgesics called as NSAIDs is one of the cause. Recently, whether pylori infected can be checked at Health Checking.

Symptom is sudden severe pain in upper abdominal area.

Typical symptom of Gastroduodenal Perforation is sudden pain in upper abdominal area. As time passes it turns into inflammation of peritoneum so that there may be the case where it is compounded by severe pain in entire abdominal area.

Most of the cases, symptoms of gastric and duodenal ulcer are preceded, so that it is important to take medical checkup at this point. Early stage symptom may differ by patients, but continuous pain in upper abdominal area, heart burn, sense of distention, and loss of appetite are common in most cases. It is said that in case of gastric ulcer, pain after meal, and in case of duodenum ulcer, non-fasting pain is come up. There may be the case where symptom of nausea or vomiting comes up.

Medical check-up when preceding inflammation symptom comes up.

When gastric and duodenal ulcer is suspected by the symptom, endoscopic exam is needed. It is difficult to judge correctly from abdominal pain symptom only. Suspected as ulcer but it isn’t, or there may be the case where it is a cancer. If not having medical check-up even symptoms come up, it is compounded gradually and finally it turns into complicating disease. Confirmed diagnosis is made by picking up the organ tissue by Endoscopic exam the performs pathology diagnosis. To diagnosis for pylori, pathology diagnosis, blood test, and/or exhaled breath test.

In case when gastroduodenal perforation is suspicious, CT Exam is performed. Air or gastric acid leakage in abdominal gives a clue for the suspicion of perforation of the digestive tract.

When perforation is developed, basic is the surgical operation.

Chemotherapy is a main treatment for gastric and duodenal ulcer. Highly effective drug medicine is developed recently so that it becomes less to perform surgery. Chemotherapy will use acid reducer like PPI or H2 blocker. For pylori positive patient, sterile filtration is performed.

In most cases, surgery is necessary for the patient who has bleeding or strong symptom even after chemotherapy, or patient who developed a perforation. Perforation part is closed by Small Open Colectomy using laparoscope, and cover it with using adipose tissue, so called as greater omentum, in abdominal tract. When the cause is cancer, or perforation is large, or for patient who repeatedly developing perforation, it may need to conduct surgery operation where half to 2/3 of belly is cut off. In case symptom is mild or early stage of symptom, chemotherapy in expecting for natural closing without performing surgical operation may be conducted.

Important to spend no-stress life style to stomach.

The most cases in gastric and duodenal ulcer, chemotherapy is good for the cure, but to prevent recurrence, it is important to have stress-free life style.
For example, avoid crapulence, care for not to take spices too much, leave oneself feeling stressed, or stop smoking.

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