Penetrating shape of ulcers. Complications of the stomach ulcer disease diagnostics of the stomach ulcers

The penetration of ulcers is a complication in which the defeat applies to nearby organs, similar to 10% of cases. This pathology meets more often in men over 40 years old.

What it is

Penetration of the ulcer of the stomach and duodenum develops due to gain inflammatory process and necrotic phenomena in the presence of chronic ulcers digestion system in the upper departments. At the same time, the defeat may be subject to: small gland, liver, pancreas and gallbladder.

The penetration of penetrating ulcers is that when it is developed, the walls of the stomach and the penetration of ulcers in neighboring organs occurs. As a result this process There is a digestion of the organs due to the formation of fibrous fabrics.

In medical practice, the penetration of ulcers in the pancreas (70%) is most often observed. If we talk about classification peptic disease WHO, penetration in this case is among the complications after bleeding and perforation.

Stages and causes of the pathological process

On the initial stage In patients, only partial ulceration of the walls of the marked organs is observed. At the same time, there is a looseuting soldering nearby tissues.
Next, ulcerative pathology is complicated by the fact that there is an increasingly strong melting of the walls of organs affected by the pathological process. Dense spikes are formed in these areas between organs. If the destruction process continues, then the tissues of these adhesions form a hole.
At the next stage there is a complete destruction of the fabric inside the ulcers. The ulcer process extends to neighboring organs, with the result that on their surface you can see the appearance of primary surface defects. At this stage of the penetration, there is a transformation of healthy tissues and their seal. As a result, there is a pronounced deformation of the designated organs.
A deep ulcer is formed on the neighboring organ, around which inflammatory tumor is formed.

In order for the peptic disease to complicate, the following conditions are necessary:

A small size of the ulcers and the defeat of all layers of the walls of the organs. In the formed cavity, a slight volume of gastric juice accumulates, so that there is a continuous development of the inflammatory process.
Formation of adhesions. In this case, the organ struck by the pathological process is quite tightly connected with localized in the neighborhood.

Signs of the pathological process

If we talk about the symptoms of the pathological process, then they are very diverse, due to the degree of development of the complication and depend on the body that was amazed by pathology.

Nevertheless, there are some typical symptoms, which makes it possible to attending a faithful diagnosis:

there is a more severe course of the disease;
epigastric painful sensations acquire chronic form, in this case, their intensity increases;
the relationship between meals and the occurrence of pain disappears;
become ineffective painkillers and antacids;
the pain of painful syndrome at night is happening;
nausea is becoming more intensive, and vomiting does not allow to feel relief;
the symptoms of the inflammatory process begin to appear, including the temperature rise, the condition of weakness and leukocytosis.

In the case of penetration of ulcers in the pancreas tissue, painful sensations are irradiated into the area of \u200b\u200bthe back or acquire the so-called hazing character.

When the penetration goes into the intestines, a fistula is formed through which the intestine content can get into the stomach. As a result, the patient opens vomiting with impurities of defecation products, food in undigested form leaves with a chair, and the belching acquires the characteristic smell of the feces.

Diagnostics of developing complications

In order to put the correct diagnosis of the doctor, the doctor will need to collect a history of the patient, obtain the results of laboratory, endoscopic and radiological studies. In patients with penetration of ulcers, such changes in blood tests are noted as regular leukocytosis in moderate degree and accelerating the erythrocyte sedimentation rate (SE). The specified disease is characterized by the presence of biochemical markers of inflammation of the liver and secondary inflammation of the pancreas.

An equally important importance in the diagnosis is given to the patient's examination in the conditions of tight fill, as a result of which you can see:

Pronounced deformation and fixation of the initial segments of the 12-rosewoman. A characteristic symptom Penetractions of ulcers is the instrument of the organ at the site of the defeat. Due to the swelling of the tissues, abundant release of mucus and the formation of blood clots from blood clots, lesions can seem smaller than they actually.
With penetrating gastric ulcers, a limited mobility of the organ is detected during the studies.

X-ray examination of the patient makes it possible to determine the signs of ulcerative pathology and the direction of penetration. Endoscopy organ gives you the opportunity to obtain an image of an affected area. In order to eliminate the malignant nature of the pathological process, the patient is prescribed a biopsy.

Treatment of the disease

Patients with diagnosed penetration of ulcers are shown surgical intervention. However, before the operation is carried out, the course is assigned intensive trainingwhich includes:

therapy aimed at eliminating the inflammatory process;
reception of anti-sized drugs;
adjusting disorders in homeostasis.

Such surgical intervention is dangerous to patient health. During the operation, 2/3 of the stomach is performed.

The penetration of ulcers is an irreversible process and is characterized by disorders of a metabolic nature in the structure of tissues, due to penetration in them. Due to the fact that the disease is very complex, its self-treatment is contraindicated. A comprehensive examination of such patients and therapy with the help of profile specialists is necessary.

Diseases of the digestive system are the most frequent complaints of patients. Complication of ulcers leads to penetration. It is observed in men against the background of inflammation of chronic ulcers.

The untreated stomach ulcer leads to penetration

general description

The penetration of stomach ulcers is a condition in which pathology falls into neighboring organs. That is, it applies to its walls. Inflammation is developing, fibrous spikes are formed (due to the ability to adhesive processes). In the affected area of \u200b\u200bthe ulcer deepens inside. When it gets through, inflammation is transferred to the wall of the nearby organ.

If the duodenal bulb is affected, the pancreas (also bile ducts and liver) affects. According to the international classification of the ICD 10 CO25 disease.

Macrobreparation No. 11 contains a small fragment of the mucous membrane of the stomach wall with a peptic defect and the pancreas located behind it. MicroPreparation No. 106 is a chronic ulcer with exacerbation, exciting three shells: mucous, subliminity and muscle.

Defeat affects nearby organs

Causes of occurrence

Allocate two main reasons for the appearance of ailment:

ulcer: The defeat of the deeper stomach layers increases the possibility of the development of penetration;
the formation of adhesions in the upper half of the abdomen - when the adjacent organs come into contact.

In addition, stress, improper nutrition, alcohol abuse lead to the formation of ulcerative disease medicinal preparationsproviding a negative impact on the inner surface of the stomach.

The mechanism of the occurrence of penetrating ulcers is as follows:

Internal organs are capable of regeneration, therefore, with penetration, a scar tissue is formed near the lesion focus. As a result, a fistive channel appears, which does not affect gastric juice.

Stomach steroid ulcer is accompanied by pain and meteorism

The steroid ulcer of the stomach has its own characteristics. It may appear in a patient who does not suffer from this disease and dyspeptic disorders. The cause is heartburn, meteorism, pain in the opposite region.

Important! Alcoholism contributes to the appearance of ulcers.

Development Stages

Pathogenesis penetration.

In the fourth stage it is possible to rebirth the disease in the cancer

Eliminate stages characterizing the development of ulcer of the stomach:

predicable (easy degree);
secondary and serious flow;
complications;
remissance after the operation.

Signs

The disease is accompanied by the following symptoms:

The peptic ulcer of the duodenum or stomach is a pathology characterized by the formation of ulcerations of the mucous membrane of the organ wall. It can cause increased acidity or the presence of microorganisms. The peptic ulcer anastomosis arises due to the resection of the stomach. The patient has pain in the upper stomach departments (from a sharp), heartburn, belching, felt an unpleasant taste in the mouth.

Peptic ulcer may occur after stomach resection

Diagnosis of the disease

In the event of suspicion of penetration, it is necessary to refer to the precinct therapist, which will determine the cause of pain in the stomach. A narrow specialist is a gastroenterologist, his profile is a gastrointestinal tract. The ulcer is diagnosed as follows:

study of the history of the disease;
clinical inspection;
appointment of laboratory tests (blood for definition sEE level and leukocytes, dairy and peer-grade acids);
endoscopic studies: Fibrogastroduodenoscopy, an x-ray of the gastrointestinal tract (to identify the flow of an ulcer defect), laparoscopy (visualization of bonding organ with stomach) and ultrasound procedure abdominal cavity (In order to study the changes in the gastrointestinal system).

Fibrogastroduodenoscopy is carried out to detect penetrating ulcers

After the diagnosis, a preoperative preparation plan is drawn up.

Methods of treatment

If there was a suspicion of this disease, it is necessary to urgently cause an ambulance emergency help. Before her arrival of the patient, it is necessary to put, ensure peace and silence, do not feed.

At the first and second degree of lesion, conservatively in stationary conditions is treated (in the absence of complications). Medicines are prescribed for the normalization of the stomach motor; diet; Regenerating drugs. The description of conservative treatment is aware of internal diseases. If this therapy does not bring a positive effect, the patient must be operated.

Conservative therapy is appointed to the patient

In the third and quadruple phase (as a rule, there are complications of the disease during this period) the defeat does not heal, only surgical intervention will help. With 1-2 type of penetrating ulcers, resection is assigned. At the initial stage of the defeat, Vagotomy is carried out with stomach drainage.

Uncomplicated peptic ulcer is treated outpatient. If the perforative pathology of the stomach or 12-rosewood is revealed, an emergency operation is necessary. IN extreme case You can apply the Taylor method: a gastric probe is introduced into the body, which provides permanent content aspiration. In addition, an active course of antibiotics is appointed.

The main purpose of treatment is to achieve scarring and healing complications in a short time. In 20% of cases of ulcers develop into oncology. You can not always catch the beginning of this transformation. Postoperative rehabilitation is desirable to conduct in medical sanatoriums in which the corresponding diet will be provided, medical therapy, healing procedures.

Taylor method suggests constant aspiration of the contents of the stomach

Forecast for recovery

At an early stage, it suffices to keep the right nutrition and reception of drugs. In the absence of treatment, the forecast is unfavorable. The complication of ulcers contributes to the occurrence of shock, cancer, stenosis and fatal outcome. Surgical intervention Enhances the chance of recovery. At the initial stages of development cancer tumor It is necessary to remove the affected part of the stomach, apply irradiation and chemotherapy.

With properly prescribed treatment, 9 of 10 patients are recovered.

As prevention, it is recommended to control the ulcer of the stomach and DPK, to observe the diet (therapeutic table No. 1), to abandon food that increases acidity. It is necessary to eat right: 3-4 times in small portions. It is impossible to eat at night. It is necessary to overcome bad habits: alcohol and nicotine contribute to the reincarnation of the disease in the oncology. It is advisable to ensure peace during the exacerbation.

Proper nutrition will help speed up recovery

Thus, the penetrating ulcer of the stomach and the 12-rosewoman - dangerous pathologyat which neighboring organs are affected. If this diagnosis is raised, you must immediately begin treatment, otherwise the outcome may be sad.

Penetraration of ulcers is higher complication Basic pathology. A similar problem is diagnosed in 10% of yazuvenes. Moreover, representatives of the strong half of humanity aged from 40 years are subject to this state.

As a rule, such a complication is developing due to inflammation formed against the background of a chronic ulcerative defect.

Clinical picture

With damage to the duodenal mucosa or the stomach, the development of ulcerative pathology occurs. If the defect in question is deepened and destroys new layers, the following states may occur:

opening of the ulcerative defect in the cavity, referred to as perforation;
opening a defect in the next body, referred to as penetration.

The penetration of stomach and duodenal ulcers represents a defect hit to other systems. And more often, the penetration of ulcers in the pancreas occurs. Since this system is located closest. Less frequently, pathology can affect bile ducts or liver.

Important: If the erosive defect penetrates the neighboring body, it means that human body inclined to adhesive processes.

The considered pathology develops inside the walls of the stomach and duodenal intestine due to inflammation. If the defect is converted into a pass-through, the inflammatory process is deposited on the wall of the neighboring organ in the zone where ulcerative education goes beyond the limits of the main affected system.

Often the yield of erosion into the neighboring body, occurs if the wound area of \u200b\u200bthe stomach or duodenum has small sizes. In the case when the erosive zone reaches more than 1.5 cm, the sores are performed, often accompanied by a shock.

The reasons

The main provocateur of the development of the considered agence is a progressive ulcerative formation with a penetrating inflammatory process. In other words, if timely not start taking gastroduodenitis or gastritis, the walls of the stomach are covered with ulcers, which are subsequently manifested in neighboring bodies.

Excessive production of hydrochloric acid plays a major role in the formation of such a complication. And provoke its excess allocation of improper nutrition, infection and ignoring therapy aimed at normalization of hydrochloric acid.

The constant effect of hydrochloric acid increases the area of \u200b\u200binflammation. The result of such negative activities is the deep defeat of the organ walls and the generated penetrating ulcer.

In addition, the development of penetration can provoke a number of certain phenomena:

kallese ulcerative education, which has no signs of regeneration and there are necrosis on the walls of the stomach;
erosive defect with a volume of up to 1.5 cm;
excessive content of gastric juice in the resulting ulcer cavity, which supports inflammation;
fast processes in the upper belly, caused by the injuries obtained due to inflammation occurring in the abdominal cavity or due to the transferred operation.

It is worth noting, more often the spikes are formed due to the serous shell covering all the abdominal cavity systems, which tries to isolate a damaged area. These actions lead to the fact that the serous shell adhesums to the dislocation zone of the lesion, which over time leads to the formation of fibrous chips that make the mobility of organs.

Stages of development of pathology

The stages of the development of the considered defect are identical for both the stomach and for the duodenum. In total, the penetrating ulcer of the stomach has four degrees of formation, namely:

at the initial stage, a superficial erosive damage of the walls of the intestinal and gastric tract is formed. As a result, an inflammatory hearth is formed. At the same time, a partial spike of an organ adjacent to the stomach is observed;
at the second stage of development, the destruction of the stomach layers is observed. At this stage, so far beyond the affected organ, the defective process does not enter. At the second stage, the penetration of ulcerative formation into the neighboring body is not yet observed;
at the third stage of development, the ulcerative defect extends to the underlying organ, forming a wound on its surface. In this case, the affected organ is deformed, the tissue is amenable to the sclerosis process and are compacted. In parallel, fibroids are also tightened by the stomach, as a result of which it is deformed;
and at the last fourth stage, cavities in which focal inflammations are observed in the penis.

It is worth noting, at the last stage, a deep ulcer is formed, which is surrounded by a tumor.

Symptomatics

If a patient has revealed a penetration, accompanied by penetration into the neighboring body, symptomatics will be the following in nature:

the emergence of strong pain. And it worries such discomfort at any time of the year, day and, regardless of food eating;
the intensity of discomfort changes. If a person has a penetrating ulcer pain arises constantly, can manifest itself in the shoulder zone, blades or to be encircling;
eliminate the pain with the familiar methods fails. Anesthetics and antacids do not bring relief. Moreover, emptying the stomach by calling vomiting also does not give a positive result.

The clinical picture is determined by the defeat of the system where the penetration of the ulcer defect occurred, namely:

If the pancreas is affected, discomfort will be a pronounced intense character, can give in the back or wear a concerning character. Parallel to the patient will disturb nausea, vomiting and temperature increase. Often, similar symptoms are confused with the development of pancreatitis. However, this condition has one difference, with pancreatitis, the pain is not systematic and is eliminated by painkillers;
When penetration into a thick intestine, a hole connects the thick intestine and stomach. With this condition, the cavalous masses fall into the gastric path, and untapped products, on the contrary, come into the intestine. A characteristic feature besides pain, there will be a defecation of non-registered foods immediately after their reception. In addition, there will be particles of fees in the lot;
If a small glance is affected. Pain occurs under the rib arc and there is an excessive weight loss;
When penetration of ulcerative pathology in the liver, symptoms will be identical as the appearance of acute hepatitis. The patient is tormented by stupid many pain In the right hypochondrium. A person feels constant nausea, while the vomit is rare. In addition, weakness is observed, fast fatigue, in the night torments insomnia, and in the daytime, on the contrary, I want to sleep;
In the case when the penetration occurs in the zone zone or fine intestine, the patient will disturb constant vomiting with an admixture of bile, no appetite and sudden weight loss;
Penetration in the diaphragm zone signals strong pain Behind the sternum, which is often confused with cardiac;
If the defect in question occurs in the retroperitoneal space - it will cause a dangerous purulent septic process with signs of intoxication, such as increased temperature Body, strong chills, tachycardia, excessive selection of sweat.

To prevent penetration into one of the neighboring organs, with ulcerative disease you need to start to fight immediately at the first symptoms. Of course, the most optimal option will be followed by food and prevent the development of the root cause of penetration.

To reveal the root cause, the gastroenterologist studies the history of the patient. After that, inspection is carried out, additional laboratory and instrumental surveys are appointed.

When determining the root cause, which caused discomfort, special attention It is paid to the presence of erosive defect or the likelihood of its education. In addition, the fact is taken into account whether pain disappears after meals. Also important is the moment on pain, whether it gives to the upper and lower limbs, neck or hand.

As for instrumental and laboratory studies, the following types of diagnostics are appointed:

the fence of the biological fluid for studying the erythrocyte sedimentation rate and to observe neurocil leukocytosis;
examination with fibrogastroduodenoscopy;
x-ray to determine the depth of the affected area;
laparoscopy. This type of diagnostics allows you to visualize the place where the defect has spread;
ultrasound examination. It is performed for a detailed inspection and analysis of all the change that occurred in the pancreas and liver, provided that erosive formation is penetrated into these organs.

After a thorough examination and diagnosis of the patient, the most optimal view of the elimination of pathology is appointed.

Treatment

If penetrating ulcerative pathology is diagnosed operational intervention. At the same time, before carrying out such manipulation, the patient needs to undergo a preparatory intensive course, which includes the following activities:

assign medicia treatment to eliminate the focus of inflammation;
reception of anti-sized drugs;
adjustment of the identified disorder of homeostasis is performed.

Important: Operational intervention of this type is undoubtedly dangerous to the health of the yazuvender. Since during the manipulation of 2 \\ 3 stomach is subject to resection.

Erosion formations that are in the second and third stage are treated with a conservative way. At the same time, similar therapy is carried out within the hospital walls and under the strict observation of the doctor. For these purposes, the following groups of medicines are appointed to the Yazwnnik:

funds normalizing the motility of the intestinal and gastric tract;
antacids group preparations;
diet food, the purpose of which to eliminate the effects of provocateurs on the affected zone;
medicinal medicines that have regenerating effects.

Important: penetrating defects that have reached the third stage are eliminated only by operational intervention. In addition, it is often the purpose of a surgical procedure and those patients who have similar pathology are at the initial stage, but do not give in treatment with medication.

Since the complication under consideration represents not only the hazard for the health, but also the life of the patient, the results of therapy are controlled by the X-ray apparatus.

As for the methods of operational intervention, more often resort to the following techniques:

draining procedure;
wagotomy;
resection.

These ways to eliminate the pathology under consideration are considered the most effective.

Forecast

When ailment is detected at the initial stage of development, the patient is recommended to get a complex of therapeutic measures and strictly adhere to the diet. If the pathology has been revealed at the later stage, immediate operation is required, and then strict control over their own health, in order to prevent the development of complications.

the appearance of malignant tumors;
development of stenosis.

IMPORTANT: Timely traveled treatment will allow forever to get rid of the ailment and lead a completely normal lifestyle.

Summarizing the above described is worth summarizing. Penetration is a negative irreversible process at which there is a violation and lesion of tissues. In view of which pathology is considered very dangerous not only for the health, but also the life of the patient. Therefore, it is strictly forbidden to attempt to self-medicate or ignore the problem.

If suspicion appeared on a similar defect, you should immediately contact the gastroenterologist and survey. Timely appeal to specialists will increase the chances of recovery.

May be developed in the form of complications. Penetration of ulcers is one of the options for the consequences of the ulcer process.

Description of the disease

Violation of the integrity of the wall of the duodenum or stomach opens the beginning of the formation of ulcers. If the ulcer continues to deepen and captures the destruction of increasingly new layers of the body of the organ, then in the further continuation of the situation may be:

- This is the opening of ulcers in the cavity
or penetration - opening of ulcers to the nearby organ.

The situation when an ulcer in its development penetrates the body of the body, which is located in the neighborhood, due to the tendency of the human body to adhesive processes. This phenomenon gives the possibility of a closer and fixed contact of the organ affected by an ulcer, with the neighboring authority.

The ulcer in the main body develops inside the wall due to the accompanying phenomenon of the inflammatory process. When the ulcer becomes a cross-cutting, inflammatory process is designed to the wall of the neighboring organ at the site of the ulcer's exit beyond the limits of the tissues of the main organ.

Typically, the development of such a mechanism is the yase exit to another organ, possibly with a small area of \u200b\u200bthe core of the main body. If the diameter of the ulcers is more than 1.5 cm, then the amount of gastric juice emerging through it does not contribute to the gradual creation of an inner body ulcer. In this case, ulcers are performed, which is often accompanied by a shock.

A stomach ulcer can penetrate:

in small seal
or in the pancreas.

The duodenal ulcer can penetrate such organs:

tolstick,
pancreas
liver,
gallways.

The reasons

The possibility of the development of the ulcer process in the main body towards the transfer of the problem to the neighboring body appears as a result of the influence of such factors:

The presence of ulcers in the duodenum or in the stomach wall.
The area of \u200b\u200bthe ulcers is small - the diameter within 1.5 cm.
The patient's body has a tendency to adhesive processes.

Stages

The appearance of penetrate ulcers takes three stages:

The ulcer is in a duodenalist or stomach and dwells in the proliferation period of the organ wall.
Between the organ with the ulcer and the neighboring authority there is a fixation of their mutual close arrangement through the adhesion process.
The spread of the inflammatory process to the projection of the future ulcers on the body of the neighboring body with the development of the ulcer itself in its wall.

Symptoms of the penetration of stomach and duodenal ulcers

At the exit of ulcers, the following signs appear to another adjacent authority:

some painful symptoms are observed, characteristic of that case, in which an organ of the ulcer process is released:
- the ulcer penetrates in a small gland - the irradiation of pain in the collarbone or right shoulder;
- in the pancreas - often appears in the back pain, can be felt in the lower back: to give one of the parties or to be encircling;
- in the colon area - the irradiation of painful symptoms occurs in the navel zone;
- in the penetration of the ulcers located in the upper stomach department, pain can be designed to the region of the heart;
the organs where the penetrated ulcer signs the appearance of symptoms characteristic of their lesion:
- with penetration of ulcers in the liver, symptoms of acute hepatitis appear,
- the same in the intestine - signs of colitis or duodenitis,
- the same in the gallways - the symptoms of acute cholangitis,
- the same in the pancreas - signs of acute pancreatitis;
appear general symptoms:
- the pain that previously appeared in the epigastric area in connection with the meal or had its daily rhythm, changed the nature and became constant and for the power of manifestation of intensive;
- there is an increase in temperature without a visible reason,
- abdominal muscles are in suspense,
- analysis changes peripheral blood - shows the presence of the inflammatory process.

Diagnostics

The disease manifests itself not very clearly, symptoms are similar to many other diseases, so the diagnosis is carried out comprehensive.

Mandatory diagnostic activities include such actions:

The specialist is a history of the patient on his complaints and observations.
Clinical manifestations of the disease are investigated, information about which zones are irradiation of pain is analyzed.
The examination includes the surrender of patients with clinical analyzes.
Radiograph of the stomach is carried out.
A mandatory measure to establish an accurate diagnosis is to conduct fibrogastroscopy.

Treatment of penetration of stomach ulcers

Ulcers whose condition is within the first and second stage are subject to conservative treatment. The course is carried out in a hospital.

The patient is prescribed:

drugs leading to a stomach motor
antacids
diet aimed at the disappearance of provocations for ulcerative processes,
in some cases, regenerating action preparations are recommended.

Due to the fact that the penetrating ulcer represents a danger to human health, the results of treatment are tracked using radiographic equipment.

Penetration ulcers that have already reached the third stage in their pathological development, it is recommended to be treated with an operational way. The same purpose is obtained by patients with ulcers. initial stagesif conservative methods do not bring the expected positive result.

These types of operations are used:

wagotomy,
resection,
draining operation.

Forecast

In the early stages of the disease, the body can be maintained within the normal range in timely treatment and observance of the diet. In later stages, operational intervention is required and attentive attitude to their health in order to prevent complications.

Negative consequences include such phenomena:

perforation of ulcers,

With timely treatment of 99 patients out of 100, a normal lifestyle is cured and lead.

If not to seek medical care or allow the development of complications, the forecast is unfavorable.

Penetration of ulcers - penetration of the ulcer of the stomach or DPK in the adjacent organs.

Prevalence. The penetration of ulcers is observed in 10-15% of patients with peptic disease, more often in men at the age of 40 with a long ulcerative history.

Causes of penetration of ulcers: The emergence of the penetration is associated with the progression of the inflammatory-necrotic process in a chronic molding ulcer.

Patomorphological changes that develop in the abdominal cavity in the penetration of ulcers, and its clinical symptoms depend on the stage of penetration of ulcers into the wall of the stomach and duodenum or in the adjacent organs. There are four stages of the development of penetration of ulcers.

In the first stage of the penetration of ulcers, as a result of the progression of a chronic inflammatory-necrotic process, a partial destruction of the walls of the stomach and duodenum occurs. Outside to the area of \u200b\u200bulcers, the adjacent organs are soldered.

In the second stage of the penetration of ulcers, there is a deep destruction of all layers of the wall of the carrier body. However, beyond its limits does not yet come out. The defect in the wall of the penetrated organ is absent. Between him and the bearing ulcers of the stomach or duodenalist are dense battles. When they are destroyed in the stomach wall, a cross-cutting defect is formed.

The third stage (superficial penetration) is characterized by the complete destruction of all layers of the stomach wall. The ulcer applies to neighboring organs with the formation of a small surface flat defect in them. The structure of tissues of penetrated organs located in the circumference of the bottom of the ulcer is violated. They are compacted, sclerized. The stomach or duodenum is significantly deformed.

In the fourth stage, deep cavities are formed in the adjacent organ or tissues. In the place of penetration is formed inflammatory tumor,

Symptoms of penetrate ulcers

In patients with penetrating ulcer disappears daily rhythm, the intensity and irradiation of pain change. It becomes more constant, long. Irradiates in the back, chest, shoulder or acquires a hazing character. The intensity of pain does not depend on food meals. There are no light gaps between paincrops. Vomiting rarely brings relief. However, with starvation, the pain decreases somewhat. Pain syndrome It is difficult to conservative treatment. It is often noted subfebilitation and leukocytosis with a shift of blood formula left, an increase in ESP.

The flow of penetrating ulcers is complicated by profuse bleeding from arrocyal vessels of adjacent organs, perforation, violation of the function of organs with the development of acute pancreatitis, acute cholecystitis. Often inflammatory infiltrate squeezes the output of the stomach or duodenum, which leads to a disturbed evacuation of food from the stomach. Penetration of ulcers in the hollow organ causes the formation of pathological fistula.

Diagnostics of penetrate ulcers

Pay attention to complaints, history. With objective inspection, Dorzal pain points are detected: Boas, Openhovsky, Herbsta. The decisive role in the formulation of the diagnosis belongs to fibrogastroscopy (deep ulcer) or the X-ray study of the stomach and duodenal intestine (deep niche, its two-lyingness; the rapid contrast hit in the colon, throwing into the gallways - signs of forming fistula).

Treatment of penetrate ulcers

Penetrating ulcers 1-2 stages are poorly amenable to conservative treatment. At the third and fourth stages of penetration, ulcers do not heal. The only radical treatment of penetrating ulcers is an operation. Patients with penetrating ulcers of the first second types of Johnson shown