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Perforated Ulcer (Peritonitis)

Dr Ganesh Ramalingam

Specialist in General Surgery

Condition

Perforated Ulcers In A Nutshell

  • A perforated ulcer is a painful condition that occurs when the lining of the stomach splits open.
  • This is a serious condition because bacteria in the stomach may infect the lining of one’s abdomen, in a condition known as peritonitis.
  • Common symptoms of peritonitis include sudden abdominal pain, fever and chills; loss of appetite; nausea or vomiting along with inability to pass motion and urine.
  • Surgery to remove infected tissue is necessary for many cases of peritonitis. The infection can spread and become life-threatening if not treated promptly.

Table of Contents

Perforated Ulcer (Peritonitis)

What Is A Perforated Ulcer?

A perforated ulcer is when the lining of your stomach splits open. This is a serious condition because the bacteria in your stomach can now escape and infect the lining of your abdomen, in a condition known as peritonitis.

What Is Peritonitis?

Peritonitis is inflammation of the tissue of the inner lining of your abdomen (peritoneum). It is a serious medical condition and requires immediate medical attention. This infection can rapidly spread to the blood which is known as sepsis and thereafter spread to the other organs. If left untreated, this may lead to multiple organ failure or cause death. In many cases of peritonitis, people will suffer from sudden and worsening stomach pain.

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What Are The Symptoms Of Peritonitis?

Common symptoms of peritonitis include:

  • sudden abdominal pain that becomes more intense
  • fever and chills
  • loss of appetite
  • nausea and vomiting
  • passing less urine than usual and inability to pass motion

Do consult your doctor immediately if you present any of these symptoms.

What Causes Peritonitis?

Peritonitis is caused by a buildup of blood, fluids or pus in your abdomen. There are two main types of peritonitis, spontaneous peritonitis and secondary peritonitis.

Spontaneous peritonitis is more often than not caused by an infection in the fluid that accumulates in your abdomen. The main factors are scarring of the liver due to long-term damage of the liver (cirrhosis) and undergoing peritoneal dialysis as a treatment for kidney failure.

Secondary peritonitis occurs as a result of an infection in another part of your body that spreads in your digestive tract. Some of the more common causes include a perforated ulcer, a ruptured appendix and digestive disorders such as Crohn’s disease or diverticulitis.

How Is Peritonitis Diagnosed?

During a consultation session, your doctor will carry out a physical examination to check if it is unusually firm or tender. If required, you would be scheduled for further tests such as:

Peritoneal fluid analysis, whereby a thin needle is used to take a sample of the fluid in your abdomen. This sample of fluid is analysed to see if it has a high white blood count which indicates an infection or inflammation. A culture of the fluid can also show if it contains bacteria.

Imaging tests such as X-rays, CT scans and MRI may be used to create pictures of your internal tissues, organs and bones.

Blood tests, which are also able to show if there is a high white blood cell count in your body which may indicate infection. A culture of your blood can also be used to determine if bacteria is present in your blood.

Why Surgery For Peritonitis?

Surgery is necessary to remove infected tissue in order to treat peritonitis in many cases. The infection may spread and become severe and life-threatening if not treated promptly.

Surgery can be used to remove infected tissue, treat the underlying cause of the infection, and prevent it from spreading to other organs in your body.

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