| ID | 234 |
|---|---|
| Name | PERFORATION OF PEPTIC ULCER |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | Management: 1. Inj. Pathedine 75mg or Morphine 15mg is given as analgesic to relieve pain. 2. Nasogastric suction. 3. Normal or dextrose saline drip (3000 c.c daily or as required). 4. Parenteral systemic antibiotics. 5. Intravenous proton pump inhibitor. 6. Laparotomy & simple closure of perforation is the operation of choice and peritoneal toileting; (Or, Laparoscopic repair & toileting). 7. Fluid is sucked out from the peritoneal cavity & then abdomen is closed. |
| Introduction | Perforation occurs in about 10% of all peptic ulcer cases & 90% are males. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: 1. Past history of peptic ulcer in more than 50% cases. History of taking NSAIDs. 2. Sudden attack of excruciating pain which is unremitting & aggravated by movement. 3. Vomiting may occur once or twice daily. 4. Referred pain to one or both shoulder. 5. Flexed knee, anxious facies, cold & sweating, rapid resp, fall of B.P, respiratory movement of abdomen is absent, board like regidity with tenderness, obliteration of liver dullness. 6. Bowel sounds are absent. 7. Plain x-ray abdomen including both dome of the diaphragm in erect posture shows free gas under the right dome of the diaphragm in 90% cases. |
| Preventions | |
| Treatment | |
| Complications | |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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