[Surgical tactics in perforating gastroduodenal ulcer]. / Taktika khirurga pri perforativnykh gastroduodenal'nykh iazvakh

Under observation were 25 patients with perforation of gastroduodenal ulcers, treated under stationary conditions for other severe affections (cardio-vascular, neurological, urological, oncological, etc). The clinical picture of ulcer perforation against the background of some other grave lesion remains not infrequently vague for a long time. This renders a negative effect on terms of establishing the proper diagnosis and operative intervention. A gravity of the basic lesion frequently necessitates some accessory methods of exploration to establish the correct diagnosis, and dictates a need for consultation of different specialists for the maximum objective estimation of the status of the organism forces, as well as for a solution of the problem concerning a feasibility of surgery, its terms and extent. Among this category of patients the mortality rate was very high (16 of 25 patients died). The surgical policy should consist in the performance of an urgent operative procedure (ulcer suturing and adequate drainage of the abdominal cavity). Gastric resection seems to be warranted only in special cases.