GI Perforation

Question 1

causes

Answer 1

UGI- ulcer, CA. D1 most comm. boerhaave transmural oes rupt. MW non transmural.
SI- CA, FB, obstruc, trauma.
LI- divertic, CA, obstruc, IDB, iatrogenic

Question 2

px

Answer 2

Abdo pain
Gen peritonitis
Hyperdynam circ- tachy, pyrexia, flushing
Shock- tachy, low BP, alt conciousness. Sepsis.

Question 3

ix

Answer 3

Hx
Exam
FBC, UE, clotting, X match
ABG
ECG
CXR, AXR- air under hemidiaph, rigler sign. 
CT- air

Question 4

Mx

Answer 4

Resus- fluid, O2, catheter, IV AB, analgesia
Medical- ONLY IF NO gen peritonism or sepsis. AB, bowel rest, PPI, radio drainage.
Surg- oversewing, resection, stoma.