Acute/Peptic Perforation Flashcards
Includes acute perforation and peptic perforation. peptic perforation is a type of acute perforation
what is an acute perforation?
full thickness injury to stomach or bowel wall
Causes of acute perforations?
Penetrating trauma
PUD
Appendicitis, Divertic
Bowel obstruction -> Volvulus, Toxic Megacolon
Cancer - Adenocarcinoma neoplasm
Connective Tissue disorders
CVD - low flow states
Infx - TB, Typhoid
What is a peptic perforation?
basically a peptic ulcer that eats all the way through the GI wall
Causes of Peptic perforations?
PUD
>65yo
H. pylori
NSAIDs
Smoking
Study of choice for peptic perforation?
CT W/Contrast
You order an abd XR for fear of a peptic perforation. What are you looking for?
“Rigler Sign”
Keep in mind, XR misses subtle free air 50% of the time
Trmnts for Peptic Perforation?
Resuscitation
PPIs
ABX
Sx Omental Patch Closure