When PERIVISTSERITE (PERIGASTRIT, PERIDUODENIT) gga soil deep penetrating gastroduodenal ulcers pain loses its necessary relationship with food, seasonality and changes its character: it becomes a constant and intense, amplified by physical exercise, change of position and shake the body. During periods of deterioration is determined by the diffuse tenderness on palpation of the abdomen, accompanied by an increase in temperature up to subfebrile numbers and an increase in ESR. Clinical swarm n e n a l I perivistserita closely linked to its localization: rear perigastrit proceeds with the intense pain mi resembling lesion of the pancreas; perigastrit pyloroduodenal field causes the phenomenon of motor insufficiency of the stomach with unobstructed gatekeeper. Far gone perigastrit leads to deformation of the stomach hourglass stomach ilgg cascade with the development of evacuation failure, shortening and emorschivanie lesser curvature of the stomach with a pull-up to her department called the pyloric ulitkoobraznym or purse string. Violation of the evacuation is manifested in a belch rotten smell, vomit remnants of food, although patients were not exhausted and dehydrated, as in pyloric stenosis, a normal skin turgor. The degree of violation of evacuation function of the stomach is always determined by X-ray examination.
Penetration ulcers - is gradually evolving rupture into surrounding abdominal organs (usually the pancreas, hepato-duodenal ligament, liver, and omentum), characterized by a gradual increase her pain phenomena during a period of time, the presence of intense constant pain, the disease, which is long , recurrent nature, dYSPePTICheSKie effects (nausea, belching, vomiting), symptoms were amazed
tion Authority, which occurred peggetratsiya, general and local signs of inflammation. Stubborn, persistent, hard kupiruemaya pain sometimes becomes paroxysmal, vomiting does not bring relief. In the upper half of the stomach defined constant rezisgentnost, accompanied by significant palpation
and percussion tenderness. Observed general symptoms: weight loss, Low-grade fever, leukocytosis with a neutrophilic shift, increased ESR. Penetration may be associated with recurrent bleeding, the development of the inflammatory process that leads to deformation of the stomach
and duodenum. If penetration into the pancreas are observed agonizing pain that extends into the back, diarrhea, emaciation, with perforated ulcer in liver patients experiencing chest pain (reactive sided pleurisy), with perforation in the gallbladder seen the pain in right hypochondrium, right half of the breast. There can be large inflammatory infiltrates, simulating a tumor. P ies t r e n o l on g and h e and detected with a "deep niche"

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