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AT ulcer perforation into the free abdominal cavity suddenly appear sharp ("dagger"), abdominal pain, often occurs fainting, while quickly arises protective muscle tension bryuginoy wall and deteriorating general condition of patients. In the future, developing a picture of peritonitis (tserez 6-8 y). Usually ulcer perforation occurs during the exacerbation, and in such cases patients emphasize that within a few days they observed heartburn, epigastric pain, vomiting, aggravation of the latter, it was much sharper, especially pain. Among the perforated ulcers occur prepiloricheskie, pyloric and duodenal e. The most likely cause perforation of ulcers located on the front wall of the duodenum. Pathognomonic radiological sign is the discovery of free gas in the abdominal cavity. Urgently needed surgery. Under limited perforation perforation means in the space bounded by adhesions. At the time of perforation clinical picture is little different from manifestations of perforation into the free abdominal cavity. D and a g n e w s to and often in retrospect, as it is based on characters limited abscess, subsequent possible late diffuse peritonitis. When a covert perforation small perforated hole concealed by the adjacent organs: small gland, the left liver lobes, pancreas, massive fibrous adhesions. The clinical picture and the first is similar to the picture of perforation into the free abdominal cavity. However, after 2-3 y patient's condition significantly improved, the pain subsided significantly, but the muscle tension in a limited area persists for 2-3 days. sometimes covered with a perforation is a source of limited abscess and fistula in the abdominal cavity. Freedoms he s th gas in the abdominal cavity is not radiological determined.

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MEGADUODENUM (DUODENALNYI stasis) - total defeat of smooth muscles of the digestive tract, resulting in slower zvakuatornoy of the duodenum. It was seen as a consequence of compression of the upper small intestine bryzheetsnoy artery, and in some cases, surgery on the artery eliminated the obstruction. It is now recognized that at least in some cases, the expansion of the duodenum is due to the weakness of its muscle layer.