Diagnosis
A perforation of the stomach is usually a very acute event, usually accompanied by severe pain. This quickly leads most of those affected to the treating doctor or to an emergency room. In this case, the patient’s medical history (doctor-patient consultation) is important for finding a diagnosis.
The doctor will ask how long the pain has existed and whether it has started suddenly. The question of previous illnesses is also important, especially whether a stomach ulcer or stomach cancer is known. Also whether there has been occasional stomach pain before can be asked.
If a perforation of the stomach is suspected, an x-ray is taken immediately. If a perforation of the stomach is suspected, the x-ray usually shows so-called free air in the abdomen. Together with the patient’s medical history, this is the most reliable indication of a perforation of the stomach. The diagnosis can only be made with certainty when surgery is performed.
What are the signs of a perforated stomach?
Since a perforation of the stomach is usually caused by a stomach ulcer, the symptoms that occur in the context of such an ulcer are to be considered as a sign of a perforation of the stomach. It should be noted, however, that a perforation of the stomach is a rare complication; there are many peptic ulcers that never occur. Symptoms of a peptic ulcer include pain in the upper abdomen, which occurs particularly shortly after eating and subsides when fasting.
A feeling of pressure in the upper abdomen, a feeling of fullness, loss of appetite as well as nausea and vomiting can also occur. If a stomach ulcer is suspected, the treating physician should be consulted. The doctor will prescribe medication that usually leads to healing of the ulcer.
There are no direct signs that occur in the days or hours before a stomach ulcer develops. It is possible that the pain that was already present in the ulcer in many people before may increase again. From the moment the stomach perforation occurs, there is in most cases sudden severe pain in the upper abdomen.
The pain can extend into the shoulder. In addition, after a short time, fever, a marked deterioration of the general condition and possibly severe circulatory problems can occur.If any of these symptoms persist, the emergency services should be called immediately. The time between the onset of symptoms and surgery is crucial for the prognosis.
The accompanying symptoms are already described above. In addition to severe pain, there may be fever and the development of shock with very low blood pressure and rapid pulse. The symptoms are primarily due to the rapidly developing peritonitis (inflammation of the peritoneum) after the peritoneum has come into contact with the acidic stomach contents.
Pain is in most cases the main symptom of gastric perforation. The pain usually occurs suddenly and is severe. It may radiate to the back or shoulder.
