Penetration of the ulcer of the stomach or duodenal ulcers

Penetration of the ulcer in neighboring organs is an original version of it is covered with a perforation. There are 3 stages of penetration: the stage of penetration through all layers of the stomach and duodenum - 39-51 %, stage of fibrous adhesions with the adjacent body - 25-30% and stage complete perforation and penetration into the substance of the adjacent body - 22-29% (Hausbruch, 1963). Most meets penetration in small gland in the body and the head of the pancreas, liver-duodenal sheaf. It is also possible penetration in the liver, gall bladder, colon or in the mesentery.
Clinically penetration of the ulcer can simulate coronary disease, tabes dorsalis, diseases of the biliary tract, pancreatitis, pancreatic cancer, and many other abdominal and thoracic disease. When diagnosed with ulcers can be suspected penetration of it in the pancreas in the case when a patient complains of pain in the back, and x-ray study found sluggishness of ulcerous zone. Indication of jaundice in history gives the right to suspect penetration or hepatic-duodenal sheaf, or in the bile ducts, or in the head of the pancreas.
Penetration occurs more often in men and undoubtedly meets the more, the longer history of the disease.
The most characteristic for the recognition of the ulcer penetration are the following 5 symptoms: pain in the back, night painful attack, the change of pace epigastric pain and ulcers, as well as the persistence of pain, despite the vigorous therapy.
Treatment of penetrating ulcers, of course, can only be operational. Operation in the form of resection in terms of penetration always seems to be more difficult and complicated and requires a lot of experience of the surgeon.
When penetration into the head of the pancreas or liver-duodenal sheaf can be created impossibility of unesenye ulcers, and then have to be limited to so-called resection to turn off, leaving ulcers. In other cases, the type of resection not fundamentally different from other resections about gastroduodenal ulcers, but at the end of the operation requires careful peritonization of the body from a fabric which cut ulcer; in some cases resection takes on the character combination, for example with resection of the liver or other organ. We should not forget that penetrating ulcers characterised by a tendency to transform into cancer, which then turns out to be germinated in the adjacent body.