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In intestinal perforation, gas may be visible under the diaphragm on chest x-ray while the patient is in an upright position. While x-ray is a fast and inexpensive to screen for perforation, an abdominal CT scan with contrast is more sensitive and specific for establishing a diagnosis as well as determining the underlying cause. [ 19 ]
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 ...
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.
The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma. A perforated appendix rarely causes a pneumoperitoneum. Spontaneous pneumoperitoneum is a rare case that is not caused by an abdominal organ rupture.
Causes include perforation of the intestinal tract, pancreatitis, pelvic inflammatory disease, stomach ulcer, cirrhosis, a ruptured appendix or even a perforated gallbladder. [3] Risk factors include ascites (the abnormal build-up of fluid in the abdomen) and peritoneal dialysis. [4]
Perforated ulcer; Other names: Ruptured ulcer: Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper gastrointestinal hemorrhage and could potentially lead to perforation. Specialty: Gastroenterology Symptoms: Abdominal pain, vomiting, nausea: Complications: Bowel perforation, sepsis ...
However, intussusception can cause a loop of bowel to become necrotic, secondary to ischemia due to compression to arterial blood supply. This leads to perforation and sepsis, which causes fever. In rare cases, intussusception may be a complication of Henoch–Schönlein purpura, an immune-mediated vasculitis disease in children. Such patients ...
Attempts at removal can have severe and even lethal effects, such as the rupture of the colon wall by catheter or an acute angle of the fecaloma (stercoral perforation), followed by sepsis. It may also lead to stercoral perforation, a condition characterized by bowel perforation due to pressure necrosis from a fecal mass or fecaloma. [14] [15]