What are lacerations and how do they differ from other wounds. How can you provide first aid for lacerations at home. When should you seek medical attention for a cut or puncture wound. What are the best ways to prevent lacerations and other injuries.

What Are Lacerations? Understanding Different Types of Wounds

Lacerations are a common type of wound that can range from minor to severe. To understand lacerations better, it’s helpful to compare them to other types of wounds:

• Laceration: A cut or tear in the skin, often with jagged edges
• Cut: A clean break in the skin, usually from a sharp object
• Puncture: A small hole caused by a pointed object piercing the skin
• Abrasion: Superficial scraping or wearing away of the skin surface

Lacerations can vary greatly in depth and severity. Some only affect the outer layers of skin, while deeper lacerations may damage underlying tissues like muscles, tendons, or blood vessels.

Characteristics of Lacerations

How can you identify a laceration? Common features include:

• Irregular, jagged edges to the wound
• Varying depth throughout the injury
• Tissue damage around the wound edges
• Bleeding, which can be profuse in deeper lacerations
• Pain and tenderness in the injured area

Common Causes of Lacerations: Everyday Hazards to Watch For

Lacerations can occur in many ways during everyday activities. Some frequent causes include:

• Accidents with sharp kitchen tools like knives or mandolin slicers
• Workplace injuries from machinery or tools
• Falls onto rough or sharp surfaces
• Sports injuries, especially in contact sports
• Car accidents resulting in impact with sharp edges
• Animal bites or scratches

Understanding these common causes can help you take precautions to prevent lacerations in various settings.

First Aid for Lacerations: Steps to Take at Home

Proper first aid is crucial for minor lacerations. Follow these steps to care for a laceration at home:

1. Clean your hands thoroughly with soap and water or use hand sanitizer
2. Rinse the wound under cool running water for several minutes
3. Clean the area around the wound with mild soap and water
4. Apply direct pressure with a clean cloth to stop any bleeding
5. Apply an antibiotic ointment to help prevent infection
6. Cover the wound with a sterile adhesive bandage or gauze

For deeper lacerations or those that won’t stop bleeding, seek medical attention immediately.

When to Seek Medical Attention for Lacerations

While many minor lacerations can be treated at home, certain situations require professional medical care. Seek immediate medical attention if:

• The laceration is deep or gaping
• Bleeding doesn’t stop after 10-15 minutes of direct pressure
• The wound is on the face or a sensitive area
• You can see muscle, fat, or bone in the wound
• The injury was caused by a rusty or dirty object
• The wound resulted from an animal or human bite
• You haven’t had a tetanus shot in the last 5-10 years

Medical Treatment for Lacerations: What to Expect at the Doctor’s Office

If you need medical attention for a laceration, here’s what you can expect during treatment:

1. Cleaning: The wound will be thoroughly cleaned to remove debris and reduce infection risk
2. Examination: The doctor will assess the depth and extent of the laceration
3. Anesthesia: Local anesthetic may be used to numb the area if stitches are needed
4. Closure: Depending on the laceration, it may be closed with stitches, staples, or medical adhesive
5. Tetanus shot: You may receive a tetanus booster if your immunization isn’t current
6. Aftercare instructions: The doctor will provide guidance on caring for the wound at home

In some cases, additional treatments like antibiotics or specialized wound care may be necessary.

Complications of Lacerations: Potential Risks and How to Avoid Them

While most lacerations heal without issues, complications can occur. Being aware of potential risks can help you seek timely treatment if needed:

Infection

Infection is a primary concern with any open wound. Signs of infection include:

• Increased redness or swelling around the wound
• Warmth or tenderness in the area
• Pus or foul-smelling discharge
• Fever or chills

To reduce infection risk, keep the wound clean and follow all aftercare instructions carefully.

Scarring

Some degree of scarring is common with lacerations, especially deeper ones. To minimize scarring:

• Follow wound care instructions precisely
• Keep the wound moist and covered during healing
• Avoid picking at scabs or stretching the wound
• Use silicone sheets or scar-minimizing products as recommended by your doctor

Delayed Healing

Factors that can slow wound healing include:

• Poor nutrition
• Smoking
• Certain medical conditions like diabetes
• Some medications

Maintain a healthy lifestyle and follow your doctor’s advice to promote optimal healing.

Prevention Strategies: Reducing Your Risk of Lacerations

While accidents happen, many lacerations are preventable. Implement these strategies to reduce your risk:

In the Kitchen

• Use proper cutting techniques and sharp knives
• Employ protective gear like cut-resistant gloves when appropriate
• Keep knives and sharp tools out of children’s reach

At Work

• Follow all safety protocols and wear required protective equipment
• Maintain focus on tasks involving sharp tools or machinery
• Report unsafe conditions to supervisors promptly

During Sports and Recreation

• Wear appropriate protective gear for your activity
• Ensure proper maintenance of equipment and playing surfaces
• Follow rules and guidelines for safe play

Around the Home

• Secure loose carpeting and remove tripping hazards
• Use caution when handling glass or other fragile items
• Keep tools and sharp objects stored safely when not in use

Long-Term Care for Laceration Scars: Minimizing Appearance and Restoring Function

After a laceration heals, you may be left with a scar. While some scarring is inevitable, there are ways to minimize its appearance and impact:

Topical Treatments

• Silicone sheets or gels can help flatten and fade scars
• Over-the-counter scar creams may improve appearance
• Sunscreen is crucial to prevent darkening of scar tissue

Medical Procedures

For more significant scars, medical treatments may be considered:

• Laser therapy to reduce redness and improve texture
• Microneedling to stimulate collagen production
• Steroid injections to flatten raised scars
• Surgical revision for very prominent or restrictive scars

Physical Therapy

If a laceration affects joint mobility or muscle function, physical therapy can help:

• Improve range of motion in affected areas
• Strengthen muscles weakened by injury
• Reduce scar tissue buildup through massage and stretching

Consult with a dermatologist or plastic surgeon to determine the best long-term care plan for your specific laceration scar.

Special Considerations for Lacerations in Children

Children are prone to cuts and scrapes, and caring for lacerations in young patients requires some special considerations:

Emotional Support

Injuries can be frightening for children. To help them cope:

• Remain calm and reassuring throughout treatment
• Explain procedures in age-appropriate terms
• Use distraction techniques during wound care
• Praise their bravery and cooperation

Pain Management

Children may be more sensitive to pain. Consider these options:

• Topical anesthetic creams for minor wounds
• Child-friendly pain relief methods like cold packs or distraction
• Appropriate dosing of over-the-counter pain medication if recommended by a doctor

Wound Care Compliance

Ensuring proper wound care can be challenging with children. Try these strategies:

• Make wound cleaning and dressing changes part of a routine
• Use child-friendly bandages or dressings when possible
• Involve the child in their care to promote understanding and cooperation

Prevention Education

Use the experience as a teaching opportunity:

• Discuss how the injury occurred and how to prevent similar incidents
• Teach age-appropriate first aid skills
• Reinforce safety rules and the importance of protective gear in sports

By addressing these special considerations, you can help ensure better outcomes and a more positive experience for children dealing with lacerations.

Cuts and puncture wounds: MedlinePlus Medical Encyclopedia

A cut is a break or opening in the skin. It is also called a laceration. A cut may be deep, smooth, or jagged. It may be near the surface of the skin, or deeper. A deep cut can affect tendons, muscles, ligaments, nerves, blood vessels, or bone.

A puncture is a wound made by a pointed object such as a nail, knife, or sharp tooth. Puncture wounds often appear to be on the surface, but may extend into the deeper tissue layers.

Symptoms include:

• 
  Bleeding
• Problems with function (movement) or feeling (numbness, tingling) below the wound site
• Pain

Infection may occur with some cuts and puncture wounds. The following are more likely to become infected:

• Bites
• Punctures
• Crush injuries
• Dirty wounds
• Wounds on the feet
• Wounds that are not promptly treated

If the wound is bleeding severely, call your local emergency number, such as 911.

Minor cuts and puncture wounds can be treated at home. Prompt first aid can help prevent infection and thereby speed healing and reduce the amount of scarring.

Take the following steps:

FOR MINOR CUTS

• Wash your hands with soap or antibacterial cleanser to prevent infection.
• Then, wash the cut thoroughly with mild soap and water.
• Use direct pressure to stop the bleeding.
• Apply antibacterial ointment and a clean bandage that will not stick to the wound.

FOR MINOR PUNCTURES

• Wash your hands with soap or antibacterial cleanser to prevent infection.
• Rinse the puncture for 5 minutes under running water. Then wash with soap.
• Look (but do not poke around) for objects inside the wound. If found, don’t remove them. Go to your emergency or urgent care center.
• If you can’t see anything inside the wound, but a piece of the object that caused the injury is missing, also seek medical attention.
• Apply antibacterial ointment and a clean bandage that will not stick to the wound.

• DO NOT assume that a minor wound is clean because you can’t see dirt or debris inside. Always wash it.
• DO NOT breathe on an open wound.
• DO NOT try to clean a major wound, especially after the bleeding is under control.
• DO NOT remove a long or deeply stuck object. Seek medical attention.
• DO NOT push or pick debris from a wound. Seek medical attention.
• DO NOT push body parts back in. Cover them with clean material until medical help arrives.

Call 911 or your local emergency number if:

• The bleeding is severe or cannot be stopped (for example, after 10 minutes of pressure).
• The person cannot feel the injured area, or it doesn’t work right.
• The person is otherwise seriously injured.

Call your health care provider right away if:

• The wound is large or deep, even if the bleeding is not severe.
• The wound is more than a quarter inch (.64 centimeter) deep, on the face, or reaching the bone. Stitches may be needed.
• The person has been bitten by a human or animal.
• A cut or puncture is caused by a fishhook or rusty object.
• You step on a nail or other similar object.
• An object or debris is stuck. Do not remove it yourself.
• The wound shows signs of infection such as warmth and redness in the area, a painful or throbbing sensation, fever, swelling, a red streak extending from the wound, or pus-like drainage.
• You have not had a tetanus shot within the last 10 years.

Keep knives, scissors, sharp objects, firearms, and fragile items out of the reach of children. When children are old enough, teach them to how to use knives, scissors, and other tools safely.

Make sure you and your child are up to date on vaccinations. A tetanus vaccine is generally recommended every 10 years.

Wound – cut or puncture; Open wound; Laceration; Puncture wound

• First aid kit
• Laceration versus puncture wound
• Stitches
• Snake bite
• Minor cut – first aid

Ball JW, Dains JE, Flynn JA, Solomom BS, Stewart RW. Skin, hair, and nails. In: Ball JW, Dains JE, Flynn JA, Solomom BS, Stewart RW, eds. Seidel’s Guide to Physical Examination. 9th ed. . St Louis, MO: Elsevier; 2019:chap 9.

Lammers RL, Aldy KN. Principles of wound management. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 34.

Simon BC, Hern HG. Wound management principles. In: Walls RM, Hockberger RS, Gausche-Hill M, eds, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 52.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Lacerations: Definition, Diagnosis & Treatment | Portland Urgent Care

Lacerations are scary when they happen, especially if you do not know what to look for or how to handle a cut. Knowing what to look for and how to handle a laceration will help you to determine the correct form of treatment. Find out everything you need to know about lacerations to make the best decisions for you and your family.

What is a laceration wound?

A laceration wound refers to a skin wound without missing skin. Usually, lacerations are caused by sharp objects. These are one of the easiest medical conditions to diagnose and easy to treat. Lacerations form by tearing the soft body tissue, that is, the top layer or layers of skin. Furthermore, lacerations are irregular tear-like wounds often caused by blunt trauma. 

Puncture wounds break more than soft tissue. Lacerations can be deep, shallow, long, short, wide, and even narrow. Minor lacerations do not usually require medical assistance as they can be treated at home with proper cleaning, ointments, and bandages. Also, minor lacerations will not bleed as much as deep lacerations. 

Deeper lacerations may require stitches if they are deep, bleeding profusely, have jagged edges, or expose muscle or fat. Seek medical attention for deep lacerations, especially cuts that will not stop bleeding. Often lacerations are misused as incisions that are caused on purpose or have clearly defined edges. 

What are the signs and symptoms of a laceration?

Lacerations are easy to spot as they refer to damage to the skin. As the skin has nerves, you will feel a sharp pain from a cut. Also, the cut skin will bleed and have a visible tear in the skin when the blood is out of the way. Often you will know when a laceration happens as it involves a cut or injury. The laceration victim will often scream in pain when the accident occurs, which is the first symptom of a cut.  

How do you describe a laceration?

Describe a laceration as a defined tear in the tissue of the skin caused by either shearing or crushing force. Often, lacerations are a result of blunt trauma. A laceration can also be described as an incomplete separation of strong tissue elements such as blood vessels or nerves. Lacerations can be caused by both sharp or dull trauma.

What is the difference between a cut and a laceration?

Cuts and lacerations are often used interchangeably as both indicate damaged skin from a blunt or sharp object. However, a cut often refers to a mild laceration as cuts do not often require more than antibacterial ointment and a bandage. Lacerations may be deeper and require pressure to stop the bleeding and even stitches depending on the depth of the injury or exposure of other parts like bone, tendons, ligaments, or muscle.  

How do you treat a wound laceration?

The first step to treat laceration is to stop the bleeding with pressure and gauze or bandage. Once the wound stops bleeding, clean the area to remove all dirt and debris. Clean by running cool water over the area and then use mild soap and water if possible. Dry with a sterile cloth. 

Next, apply antibiotic ointment and cover the wound with a sterile gauze bandage and medical tape. For smaller lacerations, use a self-sticking bandage for the wound. Clean and replace bandages daily until the wound heals. For smaller cuts, you may be able to use skin closure strips. Avoid using liquid bandages for cuts without consulting a doctor first. 

For deeper lacerations, go to the doctors for stitches. If you can see anything other than the first layer of skin, you also need to go to the doctor for proper treatment. If a cut measures larger than half an inch or has a large gaping wound, it probably requires stitches. 

Moreover, the location of a wound may require stitches to stay shut, such as on a joint, face, near the eye, or in the genital area. Another indication that a laceration requires medical attention is a risk of infection or disease such as a rusty nail, a scratch or bite, or another potentially contaminated item. Finally, prolonged bleeding requires medical assistance. 

After a few days, even if treating a minor laceration, you need to look for signs of infections or complications. Look for fever, chills, redness, swelling, white or yellow pus or drainage from the wound, or worsening pain. Do not wait to see a doctor if any of these symptoms occur; seek medical attention quickly. 

Can a laceration heal without stitches?

Eventually, a laceration will heal on its own without stitches. However, stitches promote faster healing, keep the wound clean from bacteria and infection, and prevent scarring. Furthermore, stitches or staples can help to reduce blood loss and reduce future complications from the wound. Lacerations can sever toes or fingers, and these cannot heal well without stitches. 

How long does it take for a laceration to heal?

Depending on the wound, it can take up to three months for the wound to fully heal. If you require stitches, the wound can heal faster in about six to eight weeks. Minor cuts and lacerations can heal in as little as two weeks, especially if the cut is very small. 

The location of the wound can impact healing as well. If the injury is on your hand, foot, knee, or elbow, it may take longer to heal as the body part moves more often. Immobilizing and injury on these parts, while frustrating, can help the cut to heal faster.  

How can I make my laceration heal faster?

The best way to help a laceration heal faster is to take proper care of the wound. Furthermore, if the cut requires stitches, then get stitches. Most importantly, keep the wound clean to prevent infection and covered to keep out dirt and debris. Avoid an unhealthy diet and drink more water to help provide the nutrients you need to heal properly. Try to eat food rich in vitamin C and antioxidants to help heal quickly. Lastly, avoid smoking and drugs of any sort to give yourself the best chance of healing. 

How deep does a cut heal?

Lacerations heal in four stages. Stage one is stopping the bleeding, also called hemostasis. Adding pressure can help to stop blood flow as the blood clots to prevent blood loss and closes the wound by making a scab, which is stage two. At this stage, you may notice inflammation as well as that helps to heal. 

Stage three involves rebuilding or growth as oxygen-rich red blood cells move to the injury and create new tissue. The last stage is maturation or strengthening, where the wound clots and heals. At this stage, you may notice itching or tightness around pink or stretched skin. From here, the body will continue to heal until the wound is gone or left with a scar. Over time, even deep cuts will heal, but stitches will help to reduce healing time. 

How do you describe a deep laceration?

A deep laceration is a severe laceration. Describe a deep laceration by the size, size, shape, orientation, and margins. You could also describe a deep laceration as a gash as it implies a longer or deeper cut. Make sure to also describe if you can see bones, muscles, or other internal parts that should not be visible.  

What is a severe laceration?

Severe lacerations are those that require stitches, are infected, or will not stop bleeding. Deep lacerations that expose internal parts are also severe. They may extend through more layers of tissue and cause significant pain. Do not hesitate to go to a doctor for a severe laceration. While minor cuts can be cared for at home, deep or severe cuts require medical attention. 

Should I see a doctor for a laceration?

If, after applying pressure, the bleeding does not stop, then you need to see a doctor for a laceration. All severe lacerations require a doctor for treatment. Additionally, if you see signs of infection or if the laceration was caused by something that could cause infection, then seek medical attention. See a doctor also if the laceration is near the eye. Signs of shock warrant a visit to the doctors as well, including a weak pulse, clammy skin, or rapid breathing. 

Signs of the wound reopening require a visit to the doctors as well. Furthermore, look for new or unexpected symptoms such as spasms, rigidity in the muscles, or near the wound. All of these symptoms may indicate complications that require professional care. 

Why choose Portland Urgent Care for laceration treatment?

Portland Urgent Care  works with a multitude of insurance companies to serve more customers. We also use a variety of integrated medical resources by combining both western and eastern medical healthcare which allows us to serve you the way your body needs. 

We offer same-day and walk-in appointments for laceration for immediate care with the best doctors. Get a dedicated treatment plan to prevent infection and help lacerations heal quickly. From bandaging to stitches, we can do everything you need to help deal with the blood and pain to get you on the road to recovery. 

Conclusion

Mild lacerations can be treated at home with antibiotic cream and a bandage. Deeper or severe lacerations that will not stop the bleed run the risk of infection or that are deep require medical attention. When in doubt, stop by Portland Urgent Care and let us look over your wound and help decide the best form of treatment to ensure a quick and safe recovery.

For more information on injuries, see our related blogs:

Common Causes & Effects of Neck Injuries

Neck Injury Treatment

Types of Back Injuries

How Do You Know If Your Back Injury Is Serious?

Types of Ankle Injuries

Common Types & Causes of Knee Injuries

How To Treat & Recover From Knee Injuries

Wrist Ligament Injuries

Wrist Injuries Causes & Treatment

Difference Between Sprains vs Strains

Peptic ulcer of the stomach and / or duodenum – City Hospital No.

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What is an ulcer?

Gastric and/or duodenal ulcer is a defect or erosion of its mucous membrane surrounded by an area of ​​inflammation. Occurs as a result of an imbalance between the “protective” factors of the gastric mucosa such as the muco-epithelial barrier, microcirculation, gastric mucus, bicarbonates, hormones (gastrin, secretin, somatostatin), active regeneration, prostaglandins and “aggression” factors – pepsin, hydrochloric acid, Helicobacter pylori.

Incidence rate.

Despite the rapid development of modern medicine and pharmacology, the emergence of the latest medical equipment, a wide range of methods for examining and treating patients, gastric ulcer remains a fairly common disease.

Trusting the statistics, it can be argued that from 6 to 14% of the population in different parts of the world suffer from stomach ulcers.

In Russia, stomach ulcers can be found in about 10% of the population. Children account for 1% of the incidence.

Men aged 40-60 are most often affected. Rarely seen in teenagers.

Risk factors

1. Genetic predisposition
2. Helicobacter Pylori
3. Smoking
4. Blood type I antigens
5. Medicines
6. Alcohol abuse
7. Irrational diet (spicy, salty, rough food)
8. Violation of the evacuation of food from the stomach
9. Reduced immunity
10. Nervous and physical strain, frequent stress
11. Meteorological influences (seasonal)
12. Insufficient amount of vitamins in the body

Depending on the location of the lesion, four types of ulcers are distinguished:

• Type I – erosion occurs in the body of the stomach and at the site of its transition to the antrum.
• Type II – association of gastric ulcer with duodenal ulcer.
• III type – lesion of the pyloric part of the stomach.
• Type IV – ulcers that occur on the lesser curvature in the upper part of the stomach, in the area of ​​​​the transition of the esophagus to the stomach. These ulcers are highly prone to malignancy.

What symptoms characterize a stomach ulcer?

Pain in the abdomen (in the epigastric region). By nature, these pains are burning, aching, pressing, squeezing. The pain radiates to the region of the left hypochondrium, lower back on the sides of the spine. Duration from 90 minutes to 3 hours. Characterized by seasonal exacerbation of pain (spring, autumn).

• Nausea
• Heartburn
• Belching (air or food)
• Vomiting (very rare)
• Constipation
• Weight loss
• Disorder of appetite (more often it increases)

Due to unbearable pain in the epigastric region, patients have to take a forced position: squatting, they grab their stomach with both hands or press against the edge of the table, lying in bed, turn on their stomach, etc.

What can be visually detected in a patient with a stomach ulcer?

• White coated tongue
• Excessive sweating, wet palms
• Anterior abdominal wall very sensitive
• Sharp pains on pressure in the epigastric region
• Appearance of tender points on the back in the region of the spine

How to diagnose peptic ulcer?:

• Complete blood count (remains unchanged when the disease is not complicated by other diseases)0037
• Fecal occult blood test – Gregersen test
• Study of the acid-forming function of the stomach (intragastric pH-metry)
• Detection of Helicobacter pylori
• X-ray method: using a contrast agent, this method allows you to detect defects in the gastric mucosa.

FEGDS (fibroesophagogastroduodenoscopy) with a biopsy from the bottom of the ulcer from 4-6 points and a mandatory cytological examination of the biopsy.

Ultrasonography (based on the use of ultrasound at a frequency of approximately 30,000 Hz to image deep body structures) identifies a defect in the stomach wall.

Electrogastroenterography (a method designed to study the motor-evacuation function of the gastrointestinal tract, based on the simultaneous registration of biopotentials from different parts of the gastrointestinal tract).

Possible complications

In most cases, an early diagnosed gastric ulcer can be cured without the development of any complications. But in those cases when the patient begins to neglect his health (the unwillingness of the patient to see a doctor, relying on the fact that the pain will pass by itself; fear of the upcoming diagnosis and procedures; material problems, etc.), he makes his body suffer more and more , which leads to the development of terrible complications:

• Bleeding
• Penetration (penetration of an ulcer into surrounding tissues and organs)
• Perforation (perforation of the ulcer)
• Peritonitis (spread of infection in the abdominal cavity, inflammation of the peritoneum)
• Perivisceritis (formation of adhesions to neighboring organs)
• Ulcer malignancy (malignancy)

Conservative treatment

• Substances that neutralize hydrochloric acid.
• Drugs that suppress the secretion of gastric juice inhibitors of the proton pump.
• Helicobacter pylori preparations
• Drugs that stimulate “protective” factors.
• Sedatives.
• Antispasmodics.

Surgical treatment

Subtotal resection of the stomach, gastrectomy, vagotomy. Apply only according to indications (bleeding from the upper gastrointestinal tract, perforation, penetration, stenosis of the pyloric sphincter, ulcer of endocrine origin – gastrinoma).

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Clinical Hospital | Acute stomach and duodenal ulcers

What is peptic ulcer of the stomach and duodenum?

An ulcer (ulcer in Latin) is a defect in the stomach wall that penetrates deeper than the mucous membrane. Sometimes an ulcerative defect extends through all layers of the stomach into the abdominal cavity (such an ulcer is called perforated or perforated).

In rare cases, an ulcer can penetrate into other organs, forming an inflammatory infiltrate, penetrating the intestines, omentum, liver, pancreas. This complication of peptic ulcer disease is called penetration.

Superficial defects of the gastric mucosa are called erosion. Unlike ulcers, erosions are much less likely to lead patients to severe consequences in the form of bleeding or perforation. However, they also require attention and treatment from a specialist doctor.

What are ulcers?

There are ulcers acute i.e. formed in a short period of time, sometimes in a few hours, and chronic that exist for months and years. If the ulcer does not heal within 2 to 3 weeks of starting drug therapy, it becomes chronic.

Acute ulcers are much more likely to lead to a sharp deterioration in a person’s condition. This is manifested by sharp pains in the upper abdomen, the stomach becomes overly tense and painful, surgeons call such a stomach “board-shaped”. Sometimes there is increasing weakness, nausea and vomiting with black masses of the “coffee grounds” type, black tarry stools – these signs speak in the resulting ulcer bleeding. Without the provision of emergency surgical care, such conditions lead to severe complications and death, even in modern reality.

A long-term ulcer is a chronic seasonal relapsing disease of the stomach and duodenum, which is characterized by the absence of complete healing of the ulcer or its recurrence after healing (relapse).

Peptic ulcer is characterized by periods of exacerbation (spring and autumn) and remission, when the symptoms subside.

Why is the disease dangerous?

Peptic ulcer is complicated by bleeding from an open peptic ulcer, formation of a through hole (perforation) in the stomach wall with spillage of stomach contents and hydrochloric acid into the abdominal cavity, cicatricial narrowing of the duodenal lumen. If an ulcer exists for more than 10 years, the risks of transforming the ulcer into a malignant tumor of the stomach or duodenum increase significantly.

Surgeons and endoscopists of the Federal State Budgetary Institution “Clinical Hospital” have extensive experience in the treatment of peptic ulcer and provide highly qualified medical care around the clock.

What are the symptoms of gastric ulcer and duodenal ulcer?

• Aching or cramping pains, of low intensity in the epigastric (pit of the stomach), more often occur on an empty stomach or immediately after eating
• Persistent heartburn, especially at night and in the morning
• Loss of appetite
• Nausea, sometimes vomiting
• Belching of rotten air, sour or bitter taste
• Heaviness in the epigastric region after eating, feeling of rapid filling of the stomach
• Bleeding from ulcers results in coffee grounds vomiting, black tarry stools (melena), increasing general weakness, malaise
• With perforation of ulcers – severe, dagger pain in the epigastric region, nausea, vomiting, painful tension of the abdominal muscles, a sharp deterioration in the general condition.

Causes of peptic ulcer disease

• Presence of resistant Helicobacter pylori bacteria in the stomach and duodenum, which is the main etiological factor in the occurrence of ulcers
• Violation of the diet
• Alcohol and tobacco abuse
• Long-term use of drugs without medical supervision
• Emotional and physical overstrain
• Genetic predisposition
• Metabolic disorders
• Hypovitaminosis.

Diagnostics

The main method for diagnosing gastric and duodenal ulcers is endoscopic fibrogastroduodenoscopy (EGD). The examination is carried out using a flexible endoscope with a diameter of 5 to 10 mm, which is carried out under conditions of light anesthesia, through the patient’s mouth into the esophagus, and then into the stomach and duodenum. The endoscope camera captures changes in the mucous membranes and broadcasts them on the screen. If necessary, during the study, the doctor can take a piece of tissue from the ulcer for histological examination, perform an endoscopic stop of bleeding by chipping a bleeding vessel in the ulcer or electrocoagulation. In some cases, a special mini-clip is applied to the vessel.

Necessary types of additional examinations for peptic ulcer of the stomach and duodenum are:

• General analysis of blood and urine
• Biochemical blood test
• Coagulogram
• Fecal occult blood test
• ECG
• Abdominal ultrasound
• X-ray of chest and abdomen
• General practitioner, gastroenterologist consultation

Treatment of peptic ulcer of the stomach and duodenum

Methods for the treatment of peptic ulcer are divided into conservative and surgical. In the case of an uncomplicated ulcer for the first time, treatment is carried out by prescribing drug therapy along with a mandatory diet. An important point is the exclusion of serious personal stress in the patient.

Currently, so-called multicomponent treatment regimens (three, less often four-component) are used.

In the treatment of peptic ulcer, the following drugs are prescribed:

• Antisecretory drugs (help suppress the secretion of hydrochloric acid): proton pump inhibitors (omeprazole, pantoprazole, esomeprazole, etc.)
• Antacids (Phospholugel, Almagel, etc.)
• Antibacterials, if Helicobacter

is detected

• Prokinetics (contribute to the acceleration of the movement of the food bolus from the esophagus to the stomach, then to the duodenum, increase the tone of the lower esophageal sphincter): domperidone (motilac, motilium), itopride (ganaton)

The treatment regimen is selected individually by a gastroenterologist in accordance with the patient’s condition and concomitant diseases.

Surgical treatment of peptic ulcer

Surgical treatment of peptic ulcer is required in case of complicated course of the disease. Most often, this need arises when a patient is suspected of perforating an ulcer with the development of peritonitis and ulcerative bleeding. In such cases, only emergency surgical care helps to avoid serious complications.

The patient is urgently undergoing endoscopic fibrogastroduodenoscopy under general anesthesia, in which an ulcer is detected and the type of complication is determined, as well as the amount of assistance needed. If acute ulcerative bleeding is detected, endoscopic hemostasis is performed by chipping the ulcer with vasoconstrictor drugs, or bleeding is stopped by argon-plasma coagulation, after achieving satisfactory hemostasis in a stable condition, the patient is transported to the ward for dynamic observation. In the future, the patient’s general condition is monitored, laboratory control, fibrogastroscopy control, approximate hospitalization time is 7-8 days, depending on the severity of the ulcer.

If it is impossible to stop bleeding by endoscopic method, an emergency operation is performed, the main task of which is to suture the bleeding vessel or resect part of the stomach.

If a perforated ulcer is suspected, the patient undergoes an emergency x-ray examination of the abdomen, which in most cases indicates the presence of free gas in the abdominal cavity. This sign indicates a defect in the wall of a hollow organ and requires emergency surgery. In some cases, it is necessary to perform computed tomography as a more effective method for diagnosing complex cases.

Perforation of the ulcer causes chemical and then bacterial peritonitis, which, if not treated in time, can lead to death! The time interval from the onset of the disease to the operation is very important here! Severe pain syndrome quickly exhausts the patient, and the growing general deterioration of the condition further worsens the situation.

During perforation, the pain syndrome is pronounced, the patient has a dagger pain in the abdomen, the patient cannot find a place for himself, cannot stand up – “Vanka-Vstanka symptom”. The only cure for this complication of peptic ulcer is emergency surgery.

A diagnostic laparoscopy is performed on the patient in the operating room under general anesthesia. Through several punctures of the anterior abdominal wall, air or carbon dioxide is injected into the abdominal cavity. Then a mini-camera and special 5 mm instruments are inserted. After the initial examination of the abdominal cavity, a decision is made on the implementation of one or another type of surgical assistance. If there is a through hole in the duodenum or stomach, it is sutured and the entire abdominal cavity is washed with special solutions to clean water. In parallel, a special thin probe is inserted into the patient’s stomach to protect the area of ​​the sutured defect and drain gastric juice. The probe can serve as a way for the introduction of food after surgery and is usually removed on the first or second day. The operation ends with the installation of one or more silicone drainage tubes. This ensures the outflow of inflammatory contents from the abdominal cavity for several days.

In some difficult cases, in the presence of generalized long-term peritonitis or technical difficulties, surgeons resort to open surgery by performing a median incision in the abdominal wall.

Approximate terms of hospitalization of the patient during laparoscopy are 4-7 days. In the case of open intervention, they depend on the severity of the patient’s condition.

With long-term ulcers of the stomach and duodenum, narrowing of the lumen of these organs may form, making it difficult for food to pass through them. This condition is called stenosis. Stenosis may be complete or incomplete. With complete stenosis, the patient cannot feed on his own. Eaten food partially or completely comes out with vomit, the patient loses weight, loses strength and desire to work, live.

This situation requires urgent hospitalization and medical support and special medical nutrition (nutrition therapy). The patient needs to quickly establish a full intake of proteins, fats and carbohydrates by installing a nutritious gastric tube and intravenous nutrition.