Disease Information for Perforated duodenal ulcer: Definition

What Are the Complications of Peptic Ulcers?

Most ulcers can be cured without complications; However, in some cases, peptic ulcers can develop potentially life-threatening complications, such as penetration, perforation, bleeding (hemorrhage), and obstruction; Penetration:An ulcer can go through (penetrate) the muscular wall of the stomach or duodenum (the first segment of the small intestine) and continue into an adjacent organ, such as the liver or pancreas; This penetration causes intense, piercing, persistent pain, which may be felt outside of the area involved—for example, the back may hurt when a duodenal ulcer penetrates the pancreas; The pain may intensify when the person changes position; If drugs do not heal the ulcer, surgery may be needed; Perforation: Ulcers on the front surface of the duodenum, or less commonly the stomach, can go through the wall, creating an opening (perforation) to the free space in the abdominal cavity; The resulting pain is sudden, intense, and steady; The pain rapidly spreads throughout the abdomen; The person may feel pain in one or both shoulders, which may intensify with deep breathing; Changing position worsens the pain, so the person often tries to lie very still; The abdomen is tender when touched, and the tenderness worsens if a doctor presses deeply and then suddenly releases the pressure; (Doctors call this rebound tenderness; ) Symptoms may be less intense in older people, in people taking corticosteroids, or in very ill people; A fever indicates an infection in the abdominal cavity; If the condition is not treated, shock may develop; This emergency situation requires immediate surgery and intravenous antibiotics;

--------------------[Merck Manual/website 2007]------------------------------

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