Question 2: How do you recognize a gastric perforation? 1. Abdominal pain
The sudden onset of severe abdominal pain is the first, most frequent and most important symptom of gastric perforation. The pain starts in the epigastric region or perforated area, and is often cutting or burning, and is usually persistent, but there are also episodes of aggravation. The pain quickly spreads to the entire abdomen and may spread to the shoulder in a stabbing or aching sensation.
2. Shock symptoms
In the early stage of perforation, patients often have a certain degree of shock symptoms, the development of bacterial peritonitis and intestinal paralysis, the patient may again appear toxic shock phenomenon.
3. Nausea and vomiting
About half of the patients have nausea and vomiting, which is not severe, and is aggravated by intestinal paralysis, as well as abdominal distension, constipation and other symptoms.
4. Other Symptoms
Fever, rapid pulse, increase in white blood cells and other phenomena, but usually appear a few hours after the perforation.1. Emergency Response
Due to emotional fluctuations or after overeating, gastric ulcer patients are prone to complicate gastric perforation, and the possibility of gastric perforation should be taken into account as soon as the relevant symptoms occur. Before the ambulance arrives, the following points should be done:
(1) Do not cover the stomach and roll around, should lie on the left side of the bed. The reason is that most of the perforation sites are located on the right side of the stomach. Lying on the left side of the bed prevents the stomach acid and food from flowing further into the abdominal cavity and worsening the condition.
(2) If the paramedics can not arrive in time, but there are some simple medical equipment on the scene, the patient can self-insertion of gastric tube. Specific method: insert the gastric tube into the nostrils, to the throat, while breathing hard swallowing, the gastric tube into the stomach. Then use a syringe to draw out the contents of the stomach, which can reduce the degree of infection in the abdominal cavity, for the patient to win the treatment time, remember that the patient must also be lying on the left side at this time.
2. Treatment
The seriousness of gastric perforation is that after perforation, a large amount of gastrointestinal fluid flows into the abdominal cavity, causing chemical or bacterial peritonitis and toxic shock, which can be life-threatening if not resuscitated in time. Small perforations without peritonitis can be treated conservatively by fasting, placing a nasogastric tube to aspirate gastric contents, giving fluids to replenish water and electrolytes, and applying antimicrobial drugs to prevent secondary infections in the abdominal cavity. Perforation after a full meal, often with diffuse peritonitis, requires emergency surgery within 6 to 12 hours. Chronic perforation, the progress is slower, perforation to adjacent organs can cause adhesions and fistula, also often require surgical treatment.