A stomach rupture, also known as gastric perforation, involves a hole forming completely through the wall of the stomach. This allows stomach contents, including acidic digestive fluids and partially digested food, to leak into the abdominal cavity. Such leakage can lead to severe inflammation and infection, making it a life-threatening medical emergency that requires immediate medical attention.
Causes of a Stomach Rupture
A common cause of a stomach rupture is a perforated peptic ulcer, an open sore that erodes through the stomach wall. These ulcers often develop due to Helicobacter pylori infection or prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs). The high acidity within the stomach can then leak into the abdominal space through this opening.
Physical trauma to the abdomen can also result in a stomach rupture. This includes blunt force injuries, such as those sustained in car accidents or falls, or penetrating injuries like stab wounds or gunshot wounds. Such external forces can directly damage the stomach tissue, leading to a tear or hole.
Stomach cancer, particularly advanced tumors, can weaken the stomach wall, increasing the risk of perforation. As cancerous cells grow, they compromise the stomach’s structural integrity, making it susceptible to rupture. Iatrogenic injuries, which occur during medical procedures, represent another cause. For instance, an endoscopy can inadvertently cause a perforation.
While extremely uncommon, overeating can contribute to a stomach rupture, especially when the stomach is already compromised. This risk is higher in individuals with certain eating disorders, such as bulimia nervosa, where repeated binge eating and vomiting can put immense strain on the stomach wall.
Recognizing the Symptoms
A stomach rupture presents with sudden, severe, and sharp abdominal pain. This pain is constant and often intensifies rapidly, signaling the immediate irritation of the abdominal lining. The abdomen may become rigid and tender to the touch, described as “board-like” rigidity.
This rigidity is a tell-tale sign of peritonitis, a serious inflammation of the peritoneum, the membrane lining the abdomen. The leaked stomach contents, including digestive acids and bacteria, trigger this inflammatory response. Patients often experience severe nausea and vomiting, which can sometimes include blood.
Systemic symptoms also develop as the body reacts to infection and inflammation. These can include chills, fever, and a rapid heart rate, indicating the body’s attempt to fight off widespread infection. Without prompt intervention, peritonitis can lead to sepsis, a life-threatening condition causing widespread inflammation and organ damage.
Diagnosis and Immediate Medical Response
Upon arrival at a medical facility, doctors will conduct a thorough physical examination, focusing on the abdomen to assess tenderness, rigidity, and distension. This initial assessment helps identify signs indicative of an acute abdominal emergency. Following the physical exam, imaging tests are ordered to confirm the presence of a perforation.
An abdominal X-ray is often the first imaging test performed, as it can reveal free air under the diaphragm, a classic sign of gastrointestinal perforation. This free air indicates that gas has escaped from the digestive tract into the abdominal cavity. A more definitive diagnostic tool is a computed tomography (CT) scan of the abdomen, which provides detailed images to precisely locate the perforation and assess fluid leakage.
Blood tests are also conducted to evaluate for signs of infection, such as an elevated white blood cell count. These tests can also assess for organ damage and electrolyte imbalances, which may occur due to the body’s response to the perforation and subsequent infection. The combination of clinical findings, imaging results, and laboratory data allows medical professionals to accurately diagnose a stomach rupture and prepare for immediate intervention.
Surgical Treatment and Recovery
A stomach rupture necessitates emergency surgical intervention to repair the hole and address contamination within the abdominal cavity. The most common surgical approach is a laparotomy, where the surgeon makes an incision in the abdomen to gain direct access to the stomach. The goal is to locate the perforation and close it, often by suturing the edges of the tear.
Following the repair, the abdominal cavity is thoroughly washed out, a process known as lavage. This procedure removes leaked stomach contents, digestive fluids, and bacteria to minimize the risk of peritonitis and subsequent infection. Drainage tubes may be placed to help remove any remaining fluids and monitor for further leakage.
The recovery period begins with a hospital stay, which can range from several days to a few weeks, depending on the severity of the perforation and any complications. Patients receive intravenous (IV) antibiotics to combat infection and IV fluids to maintain hydration and electrolyte balance. The reintroduction of a diet is gradual, starting with clear liquids and slowly progressing to solid foods as the digestive system recovers. The long-term prognosis depends on how quickly the diagnosis and surgical treatment were administered, as early intervention improves outcomes.