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A CT scan is the preferred method of diagnosis; however, free air from a perforation can often be seen on plain X-ray. [2] Perforation anywhere along the gastrointestinal tract typically requires emergency surgery in the form of an exploratory laparotomy. [2] This is usually carried out along with intravenous fluids and antibiotics. [2]
Gene Clark (1944–1991, aged 46) had perforated ulcer and died on May 24, 1991. Doug Hepburn (1926–2000, aged 74) had a perforated ulcer and died on November 22, 2000. Philip Agee (1935–2008, aged 72) had a perforated ulcer and died on January 7, 2008. Barbara Bush (1925–2018, aged 92) was treated for a perforated ulcer in November 2008. [9]
The bowel may be perforated. [4] Gas within the abdominal cavity seen on CT is understood to be a diagnostic sign of bowel perforation ; however intra-abdominal air can also be caused by pneumothorax (air in the pleural cavity outside the lungs that has escaped from the respiratory system ) or pneumomediastinum (air in the mediastinum , the ...
Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, and constipation.Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischemia or perforation from prolonged distension or ...
Ogilvie syndrome, or acute colonic pseudo-obstruction is the acute dilatation of the colon in the absence of any mechanical obstruction in severely ill patients. [1]Acute colonic pseudo-obstruction is characterized by massive dilatation of the cecum (diameter > 10 cm) and right colon on abdominal X-ray.
A bowel regimen should also be started to ensure that bowel movements become normal. Opioid pain medication should be avoided as these medications can slow colonic motility and possibly worsen constipation. The key to management and prognosis is identifying the cause or causes of the underlying constipation.
Perforated diverticulitis often requires surgery due to risks of infection or recurrence. Recurrent diverticulitis may required resection even in the absence of perforation. Bowel resection or repair is typically initiated earlier in patients with signs of infection, the elderly, immunocompromised, and those with severe comorbidities. [16]
Stercoral perforation [1] is the perforation or rupture of the intestine's walls by its internal contents, such as hardened feces or foreign objects. Hardened stools may form in prolonged constipation or other diseases which cause obstruction of transit, such as Chagas disease, Hirschprung's disease, toxic colitis, hypercalcemia, and megacolon.