Perforated viscus Flashcards
1
Q
What is it
A
- Organ with abdo opening
- Mostly chest + abdo
- Perforated peptic ulcer or colon IBD, Cancer
2
Q
What causes it
A
- Injury/ blunt trauma
- Elderly – aspirin, NSAIDs, steroids
- Alcohol + drugs
- Infections
3
Q
What is the presentation
A
- Fever
- Hypotension
- Tachycardia
- Nausea + vom
- Abdo pain – rigid when touched/ sharp + stabbing
- Can cause pneumoperitoneum (air under diaphragm)
4
Q
What investigations
A
- X-ray - sit up 10 mins before
- CT = more sensitive
5
Q
What is the management
A
- Analgesia + fluid balance
- Open surgery repair
- lower GI – severe sepsis
-upper GI – usually sterile
but can chemical peritonitis (irritants in bile, blood)
- lower GI – severe sepsis
- Laproscopy
- Abx
