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Это жизнеугрожающее состояние, требующее немедленной диагностики и медицинской помощи [1](https://centr-hirurgii-spb.ru/diseases/perforativnaya-yazva-zheludka-i-dvenadczatiperstnoj-kishki/)[3](https://centr-hirurgii.ru/surgery/abdominalnaya-khirurgiya/ekstrennaya-obshchaya-khirurgiya/perforativnaya-yazva-zheludka-i-dvenadtsatiperstnoy-kishki/). \n\nВыделяют: \n* **Перфорацию хронической язвы** — прободению предшествует длительный период существования язвенного дефекта [6](https://mc21.ru/articles/probodnaya-yazva-zheludka/). \n* **Перфорацию острой язвы** — дефект возникает при резко возникшей и быстро прогрессирующей язве без лечения [5](https://ProBolezny.ru/probodnaya-yazva-zheludka-i-dpk/).\n\n\n\n## Причины\nПерфорация — осложнение язвенной болезни [5](https://ProBolezny.ru/probodnaya-yazva-zheludka-i-dpk/). Некоторые причины: \n* **Хронические язвы** — в 80–90% случаев прободение возникает на фоне длительно существующей язвы, которая углубляется вплоть до разрушения всех слоёв желудочной стенки [6](https://mc21.ru/articles/probodnaya-yazva-zheludka/). \n* **Инфекция Helicobacter pylori** — бактерия повреждает слизистую оболочку желудка, усиливает воспаление и выработку соляной кислоты [6](https://mc21.ru/articles/probodnaya-yazva-zheludka/). \n* **Острые язвы** — возникают на фоне критических состояний (инфаркт миокарда, обширные ожоги, сепсис, почечная недостаточность) [6](https://mc21.ru/articles/probodnaya-yazva-zheludka/).\n\n## Симптомы\nНекоторые симптомы перфорации язвы: \n* **Резкая (кинжальная) боль** в животе, которая локализуется вначале в эпигастральной области или в правом подреберье, а затем быстро распространяется по всему животу [4](https://www.fdoctor.ru/poliklinika/hospital-center/depart-obshchaya-khirurgiya/disease-perforativnaya-gastroduodenalnaya-yazva/)[9](https://volynka.ru/Diseases/Details/566). \n* **Общие симптомы**: сухость во рту, жажда, тошнота [4](https://www.fdoctor.ru/poliklinika/hospital-center/depart-obshchaya-khirurgiya/disease-perforativnaya-gastroduodenalnaya-yazva/)[9](https://volynka.ru/Diseases/Details/566). \n* **У 30–40% больных** — рвота рефлекторного характера, учащающаяся при прогрессировании перитонита [4](https://www.fdoctor.ru/poliklinika/hospital-center/depart-obshchaya-khirurgiya/disease-perforativnaya-gastroduodenalnaya-yazva/)[9](https://volynka.ru/Diseases/Details/566). \n\nВозможен период ложного выздоровления: в это время боль стихает, общее состояние улучшается, но потом симптомы возвращаются с новой силой [5](https://ProBolezny.ru/probodnaya-yazva-zheludka-i-dpk/).\n\n## Диагностика\nДля диагностики перфорации язвы используют: \n* **Обзорную рентгенографию органов брюшной полости** — обнаруживает свободный газ в брюшной полости, свидетельствующий о прободении органа [1](https://centr-hirurgii-spb.ru/diseases/perforativnaya-yazva-zheludka-i-dvenadczatiperstnoj-kishki/)[10](https://gkb-luki.tmbreg.ru/images/docs/2024/11/Info_1655_01112024.pdf). \n* **Компьютерную томографию (КТ) брюшной полости** — позволяет выявить свободный газ в брюшной полости, свободную жидкость, утолщение желудочной или дуоденальной стенок в зоне язвы, обнаружить язву и перфоративное отверстие [10](https://gkb-luki.tmbreg.ru/images/docs/2024/11/Info_1655_01112024.pdf). \n* **Ультразвуковое исследование (УЗИ) органов брюшной полости** — помогает выявить свободный газ и свободную жидкость в брюшной полости [10](https://gkb-luki.tmbreg.ru/images/docs/2024/11/Info_1655_01112024.pdf).\n\n## Лечение\n**Лечение перфорации язвы возможно только хирургическим путём** [3](https://centr-hirurgii.ru/surgery/abdominalnaya-khirurgiya/ekstrennaya-obshchaya-khirurgiya/perforativnaya-yazva-zheludka-i-dvenadtsatiperstnoy-kishki/). Консервативная терапия неэффективна [3](https://centr-hirurgii.ru/surgery/abdominalnaya-khirurgiya/ekstrennaya-obshchaya-khirurgiya/perforativnaya-yazva-zheludka-i-dvenadtsatiperstnoy-kishki/). Некоторые варианты хирургических вмешательств: \n* **Ушивание перфорации** — проводится в большинстве случаев [2](https://MedAboutMe.ru/articles/vse_o_probodnoy_yazve_kak_raspoznat_i_chem_lechit/). \n* **Иссечение области перфорации** — при необходимости проводят пилоропластику (расширение канала привратника) и ваготомию (рассечение ветви блуждающего нерва) [2](https://MedAboutMe.ru/articles/vse_o_probodnoy_yazve_kak_raspoznat_i_chem_lechit/). \n* **Резекция желудка** — крайний случай, когда невозможно осуществление первых двух вариантов [2](https://MedAboutMe.ru/articles/vse_o_probodnoy_yazve_kak_raspoznat_i_chem_lechit/). \n\nЧаще всего ушивание, иссечение перфорации и другие операции проводятся лапароскопическим путём [2](https://MedAboutMe.ru/articles/vse_o_probodnoy_yazve_kak_raspoznat_i_chem_lechit/).","linksData":[{"sourceId":1,"url":"https://centr-hirurgii-spb.ru/diseases/perforativnaya-yazva-zheludka-i-dvenadczatiperstnoj-kishki/","shownUrl":"https://centr-hirurgii-spb.ru/diseases/perforativnaya-yazva-zheludka-i-dvenadczatiperstnoj-kishki/","title":"Перфоративная язва желудка и двенадцатиперстной кишки: лечение, причины, симптомы заболевания","shortUrl":"centr-hirurgii-spb.ru","isTranslated":false,"description":"","greenUrl":"centr-hirurgii-spb.ru"},{"sourceId":2,"url":"https://MedAboutMe.ru/articles/vse_o_probodnoy_yazve_kak_raspoznat_i_chem_lechit/","shownUrl":"https://MedAboutMe.ru/articles/vse_o_probodnoy_yazve_kak_raspoznat_i_chem_lechit/","title":"Прободная язва желудка и двенадцатиперстной кишки: причины, симптомы и лечение | MedAboutMe","shortUrl":"MedAboutMe.ru","isTranslated":false,"description":"","greenUrl":"MedAboutMe.ru"},{"sourceId":3,"url":"https://centr-hirurgii.ru/surgery/abdominalnaya-khirurgiya/ekstrennaya-obshchaya-khirurgiya/perforativnaya-yazva-zheludka-i-dvenadtsatiperstnoy-kishki/","shownUrl":"https://centr-hirurgii.ru/surgery/abdominalnaya-khirurgiya/ekstrennaya-obshchaya-khirurgiya/perforativnaya-yazva-zheludka-i-dvenadtsatiperstnoy-kishki/","title":"Перфоративная язва желудка и двенадцатиперстной кишки, лапароскопическое ушивание перфоративной язвы","shortUrl":"centr-hirurgii.ru","isTranslated":false,"description":"","greenUrl":"centr-hirurgii.ru"},{"sourceId":4,"url":"https://www.fdoctor.ru/poliklinika/hospital-center/depart-obshchaya-khirurgiya/disease-perforativnaya-gastroduodenalnaya-yazva/","shownUrl":"https://www.fdoctor.ru/poliklinika/hospital-center/depart-obshchaya-khirurgiya/disease-perforativnaya-gastroduodenalnaya-yazva/","title":"Перфоративная гастродуоденальная язва и двенадцатиперстной кишки - лечение в Госпитальном центре Семейный доктор","shortUrl":"fdoctor.ru","isTranslated":false,"description":"","greenUrl":"fdoctor.ru"},{"sourceId":5,"url":"https://ProBolezny.ru/probodnaya-yazva-zheludka-i-dpk/","shownUrl":"https://ProBolezny.ru/probodnaya-yazva-zheludka-i-dpk/","title":"Прободная язва желудка и ДПК (перфорация язвы)","shortUrl":"ProBolezny.ru","isTranslated":false,"description":"","greenUrl":"ProBolezny.ru"},{"sourceId":6,"url":"https://mc21.ru/articles/probodnaya-yazva-zheludka/","shownUrl":"https://mc21.ru/articles/probodnaya-yazva-zheludka/","title":"Прободная язва желудка: симптомы, осложнения, диагностика, лечение, реабилитация","shortUrl":"mc21.ru","isTranslated":false,"description":"","greenUrl":"mc21.ru"},{"sourceId":7,"url":"https://klinikabudzdorov.ru/diseases/probodnaya-yazva-zheludka/","shownUrl":"https://klinikabudzdorov.ru/diseases/probodnaya-yazva-zheludka/","title":"Прободная язва желудка – причины, симптомы, диагностика и лечение у взрсослых | «Будь Здоров»","shortUrl":"klinikabudzdorov.ru","isTranslated":false,"description":"","greenUrl":"klinikabudzdorov.ru"},{"sourceId":8,"url":"https://OpenClinics.ru/bolezni/yazva/probodnaya-yazva/","shownUrl":"https://OpenClinics.ru/bolezni/yazva/probodnaya-yazva/","title":"Прободная язва: что это, лечение, симптомы, причины","shortUrl":"OpenClinics.ru","isTranslated":false,"description":"","greenUrl":"OpenClinics.ru"},{"sourceId":9,"url":"https://volynka.ru/Diseases/Details/566","shownUrl":"https://volynka.ru/Diseases/Details/566","title":"Перфоративная язва желудка и двенадцатиперстной кишки - диагностика и лечение в Москве. 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