On a calm weekend morning, a 52-year-old man suddenly felt a sharp pain in his abdomen, which had not only not eased, but worsened over time. He tried to endure what he thought might be a normal stomach ache until he began to experience abdominal tenderness and hardening of his abdominal muscles, which eventually forced him to go to the emergency room. The results of the examination revealed that he had a gastric perforation – a medical emergency that could have been life-threatening. This case is a strong reminder that gastric perforation, while uncommon, can have extremely serious consequences. So, what exactly is a gastric perforation, why does it happen, and how is it different from other stomach diseases?
Basic Cognition of Gastric Perforation: When the Stomach Wall Is "Breached"
Definition and mechanism of gastric perforation
Gastric perforation, medically known as gastric wall penetration, is a complete rupture of the stomach wall, allowing gastric contents to leak into the abdominal cavity. This condition is not only extremely dangerous, but if left untreated, it can quickly develop into peritonitis, and even cause infection and poisoning, posing a serious threat to the life of patients.
The occurrence of gastric perforation is usually associated with a variety of factors. The most common causes include long-term untreated gastric ulcers and damage to the gastric mucosa due to long-term use of certain medications, particularly nonsteroidal anti-inflammatory drugs. In addition, stomach cancer or trauma can also cause gastric perforation.
Triggers of gastric perforation
Gastric ulcers: Long-term gastric acid erosion can lead to ulcer formation and eventually erosion to the full thickness of the stomach wall, leading to perforation.
Effects: Frequent use of anti-inflammatory drugs, such as aspirin or other nonsteroidal anti-inflammatory drugs, may damage the gastric mucosa and increase the risk of perforation.
Physical injuries: such as direct stomach injuries caused by traffic accidents, falls, or other violent impacts.
Malignant disease: Malignant tumors such as stomach cancer erode the stomach wall and may eventually lead to perforation.
Initial symptoms and recognition of gastric perforation
Typical symptoms of gastric perforation include sudden, severe epigastric pain that can quickly spread throughout the abdomen. Pain is often accompanied by nausea, vomiting, and tenderness and muscle tightness in the abdomen. The sudden onset and severity of these symptoms is key to distinguishing them from ordinary stomach pain or other stomach disorders.
Clinical signs of gastric perforation: red flags should not be ignored
Gastric perforation is a medical emergency that manifests as a breach of the integrity of the stomach wall, often accompanied by severe abdominal pain. The pain is usually sudden and well-located, mostly in the upper abdomen. Patients may describe the pain as "being pierced by a knife." In addition to pain, a perforated stomach can cause tightness in the abdominal muscles, which is a protective response designed to reduce movement in the abdomen to reduce the sensation of pain.
Symptomatically, gastric perforation can also trigger nausea and vomiting, which are caused by inflammation and infection in the abdominal cavity. As the disease progresses, people may also experience fever and increased heart rate, which are part of the body's response to acute infection and inflammation. In addition, due to the leakage of the contents of the lumen, such as stomach acid and food debris, into the abdominal cavity, the patient's condition can deteriorate rapidly, manifesting as a systemic inflammatory response and even shock.
The clinical presentation of gastric perforation may be similar to that of some other gastric conditions, such as acute gastritis or gastric ulcers, but the symptoms of gastric perforation are usually more severe and sudden. Therefore, for sudden, severe abdominal pain, doctors usually prioritize the possibility of gastric perforation and quickly proceed to further diagnostic tests.
Serious effects on the human body: potentially fatal consequences
Gastric perforation is not just a localized gastric problem, its effects are systemic. Leakage of gastric contents into the abdominal cavity due to perforation causes chemical peritonitis and may later develop into bacterial peritonitis, which is caused by the entry of bacteria from the stomach into a sterile abdominal environment. Bacterial peritonitis is a serious abdominal infection that can spread rapidly, causing a widespread inflammatory response in the abdominal cavity that can lead to a high mortality rate if left untreated.
Because of peritonitis, the entire abdominal cavity of a patient may become very sensitive, and the slightest touch or movement can cause severe pain. In addition, inflammation can lead to a buildup of fluid in the abdominal cavity, forming ascites, which further increases abdominal pressure and affects respiratory and cardiovascular function. Long-term hypotension and infection can lead to multi-organ dysfunction syndrome, which is caused by damage to various organs of the body due to prolonged hypoperfusion and inflammatory responses.
Gastric perforation can also cause acute gastric bleeding, which is due to damage to blood vessels near the site of the perforation. This bleeding can range from mild intragastric bleeding to heavy bleeding due to severe arterial rupture. In either case, acute gastric bleeding is a critical condition that requires urgent therapeutic intervention.
In addition to the direct physiological effects, gastric perforation can cause serious psychological and social problems. Due to the sudden onset and severity of the disease, patients and their family members may face extreme psychological stress and anxiety. Prolonged hospital stays and rehabilitations during treatment can be financially burdensome and distressing for patients and their families.