Summary about Disease
Gastric perforation is a hole that develops through the wall of the stomach. This allows stomach contents to leak into the abdominal cavity, leading to peritonitis (inflammation of the peritoneum), a severe and potentially life-threatening condition. It requires immediate medical attention.
Symptoms
Sudden, severe abdominal pain (often described as a "knife-like" sensation)
Rigid or board-like abdomen
Tenderness to the touch
Nausea and vomiting
Fever
Rapid heart rate
Rapid breathing
Inability to pass gas or stool
Abdominal distension
Signs of shock (e.g., dizziness, confusion, loss of consciousness)
Causes
Peptic ulcers: These are the most common cause of gastric perforation.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Long-term use increases the risk.
Infections: Helicobacter pylori infection weakens the stomach lining.
Trauma: Blunt or penetrating abdominal injuries.
Gastric cancer: Rarely, cancer can erode the stomach wall.
Swallowing a corrosive substance: Accidental or intentional ingestion of acids or alkalis.
Medical procedures: Rare complications of endoscopy or other procedures.
Medicine Used
Intravenous (IV) antibiotics: Broad-spectrum antibiotics to combat peritonitis.
Proton pump inhibitors (PPIs) or H2 receptor antagonists: To reduce stomach acid production.
Pain medications: Analgesics for pain management.
Fluid resuscitation: IV fluids to treat dehydration and shock. Note: Surgery is the primary treatment for gastric perforation, and medications are used as supportive therapy.
Is Communicable
Gastric perforation itself is not communicable. However, if the underlying cause is an H. pylori infection, that infection *can* be communicable, but it doesn't automatically cause perforation. *H. pylori* is typically spread through contaminated food or water, or through direct contact with saliva or other bodily fluids.
Precautions
If you have a peptic ulcer, follow your doctor's recommendations for treatment and management.
Avoid long-term or excessive use of NSAIDs. If necessary, take them with food and/or a PPI.
Avoid smoking and excessive alcohol consumption, as they can irritate the stomach lining.
Practice good hygiene to prevent H. pylori infection (wash hands thoroughly, ensure food is properly prepared).
Seek immediate medical attention for any sudden, severe abdominal pain.
How long does an outbreak last?
Gastric perforation is not an outbreak-related disease. It is an acute, individual medical emergency that requires immediate treatment. The duration of the illness depends on how quickly it is diagnosed and treated with surgery and supportive care. Without treatment, it can be rapidly fatal.
How is it diagnosed?
Physical examination: Assessing abdominal tenderness, rigidity, and vital signs.
Imaging studies:
X-ray of the abdomen: Can reveal free air in the abdominal cavity, a sign of perforation.
CT scan of the abdomen: Provides more detailed images and can help identify the location and cause of the perforation.
Blood tests: To check for signs of infection, inflammation, and organ dysfunction.
Upper endoscopy: Occasionally, an endoscopy may be performed to directly visualize the stomach lining, but this is less common due to the risk of exacerbating the perforation.
Timeline of Symptoms
Symptoms typically develop rapidly, over a matter of hours:
Initial Phase: Sudden, severe abdominal pain.
Within hours: Pain worsens, abdomen becomes rigid, nausea and vomiting develop.
Later stages: Fever, rapid heart rate, rapid breathing, signs of shock appear if not treated.
Important Considerations
Gastric perforation is a life-threatening medical emergency.
Prompt diagnosis and treatment (usually surgery) are crucial for survival.
Delay in treatment can lead to severe complications, including sepsis, shock, and death.
Individuals with risk factors (e.g., peptic ulcers, NSAID use) should be particularly vigilant for symptoms.
Even after surgical repair, complications can occur, requiring close monitoring.