Injury of a hernia and perforation of an ulcer, causes, symptoms, first emergency medical care.

Injury of a hernia is a condition in which the hernial contents are suddenly squeezed in the hernial opening, which is a very dangerous complication in patients with hernia. Hernias on the abdomen are infringed, as a rule, with tension of the abdominal muscles as a result of weight lifting, with severe coughing. More often this phenomenon is observed in men. 

Symptoms of infringement of a hernia.

Suddenly, acute pain occurs in the hernia or only in the abdomen. The hernial protrusion increases. It becomes dense and often painful when palpated. A small hernia, which was previously periodically adjusted by itself, is not fixed. Quite often, nausea and vomiting appear. Infringement of the intestinal loops leads to severe intoxication, there are signs of acute intestinal obstruction.

even in case of involuntary reduction of a restrained hernia. This is necessary to exclude the possible necrosis of part of the intestine. Direct hernia on their own at home should not be. It is forbidden to eat, drink, inject painkillers and antispasmodics.

Ulcer perforation, causes, symptoms, first aid.

Perforation of an ulcer is accompanied not only by pain, but also by internal bleeding, the scale of which cannot be determined immediately, so the patient needs emergency care. Perforation of an ulcer is a serious complication of acute or chronic peptic ulcer of the stomach or duodenum. This pathology is more often detected in men..

Symptoms of perforation of an ulcer.

Perforation of an ulcer in the stomach or duodenum is characterized by the appearance of sharp pain in the epigastric region, which occurs suddenly, like a dagger. In this case, or shortly before this, vomiting may occur. The patient tries not to move. The skin is pale, there is a slight bluedening of the lips, the appearance of cold sweat. The patient breathes shallowly, as a deep breath intensifies the pain.

The pulse is normal or rapid, and the arterial pressure is reduced. Body temperature is within normal limits. The abdomen is not involved in breathing, retracted. When feeling it, muscle tension and soreness are noted. After 5-6 hours, a decrease in pain and tension of the abdominal muscles is characteristic, the patient’s well-being improves. There may be agitation, palpitations, fever, increasing bloating, often stool and gas retention.

After 10-12 hours, pronounced signs of diffuse peritonitis appear. If perforation of the ulcer is accompanied by massive bleeding, then marked pallor, a significant decrease in blood pressure, a frequent pulse, and loss of consciousness quickly occur. Vomit when perforated ulcers look like coffee grounds. With massive bleeding and profuse vomiting, they may have streaks of fresh blood.

First Aid Emergency Care.

The patient needs urgent hospitalization in the surgical department. Carrying is carried out on a stretcher, the patient is in a supine position, with legs bent at the knees. In this position, the abdominal muscles are less tensed. For signs of internal bleeding, put an ice pack on your stomach.

In a serious condition, prior to hospitalization, the patient is injected subcutaneously, intravenously, intramuscularly with cardiovascular preparations (2 ml of cordiamine, 1-3 ml of 10% sulfocamphocaine), give oxygen. You can not enter painkillers. If the diagnosis of perforated ulcer is beyond doubt, this is an indication for urgent surgery.

Based on the book “Quick help in emergency situations”.
Kashin S.P..

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