Medical expert of the article
New publications
Penetration of gastric and 12-rectal ulcer
Last reviewed: 08.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Ulcer penetration is the penetration of an ulcer into adjacent organs and tissues. Ulcers of the posterior wall of the duodenal bulb and postbulbar ulcers penetrate mainly into the head of the pancreas; less often - into the large bile ducts, liver, hepatogastric ligament, very rarely - into the large intestine and its mesentery.
Mediogastric ulcers most often penetrate into the body of the pancreas and the lesser omentum.
[ Symptoms of ulcer penetration
A penetrating ulcer is characterized by the following manifestations:
- pain in the epigastric region becomes intense and constant, it loses its previously characteristic daily rhythm and connection with food intake;
- a characteristic irradiation of pain appears depending on which organ the ulcer penetrates. When penetrating the pancreas, the pain irradiates mainly to the right, less often to the left lumbar region; irradiation to the back is quite often observed or the pain takes on a girdle-like character;
- with penetration of a gastric ulcer into the lesser omentum, pain radiates upward and to the right (sometimes to the right shoulder, collarbone); with penetration of high ulcers, pain may radiate to the heart region; with penetration of a postbulbar ulcer into the mesentery of the colon, pain radiates downward and to the navel;
- in the penetration projection, severe local pain is determined and, quite often, an inflammatory infiltrate;
- symptoms of damage to the organs into which the ulcer penetrates appear;
- body temperature rises to subfebrile.
Laboratory and instrumental data
- OAK: neutrophilic leukocytosis and increased ESR are noted.
- FGDS: penetrating ulcers are characterized by round or polygonal edges, rising in the form of a ridge around the ulcer. The ulcer crater is deep.
- X-ray examination of the stomach: the depth of the ulcer increases significantly, the mobility of the area in which the ulcer is located is limited.
- Laparoscopy: it is possible to directly see the adhesion of the organ into which the ulcer has penetrated, respectively, to the stomach or duodenum.
- Ultrasound of the abdominal organs: it is possible to see an altered acoustic picture of the liver or pancreas when the ulcer penetrates into these organs.