Perforated viscus Flashcards
1
Q
What is the definition of perforated viscus?
A
An organ with an abnormal opening
2
Q
What is the mortality rate of perforated viscus?
A
Mortality around 30-50%
3
Q
What is the pathology of perforated viscus?
A
• Leakage = peritonitis
4
Q
What are the risk factors/aetiology of perforated viscus?
A
- Immunocompromised
- Co-morbidities
- Appendicitis
- Diverticulitis
- Stomach ulcer – inc. NSAIDs
- Gallstones/gallbladder infection
- Inflammatory bowel disease
- Cancer of the GI tract
- Trauma
- Bacteria/bile/stomach acid/partially digested food/stool in the abdominal cavity
- Smoking
- Alcohol
5
Q
What are the signs and symptoms of perforated viscus?
A
- Sudden and severe abdominal pain
- Rigidity, involuntary guarding and diffuse rebound tenderness
- Nausea/vomiting
- Abdominal distention
- ↓ urine, stools and gas
- Hypotensive
- Tachypneic
- Tachycardic
- Febrile
6
Q
What diseases present similarly to perforated viscus?
A
- AAA
* Haemoperitoneum
7
Q
What are the investigations carried out for a suspected perforated viscus?
A
- X-ray
- CT
- US
- FBC
- Cross match
- Coagulation screen
- Blood gas
- Lactic acid
- Kidney bloods
- Liver bloods
- Lipase/amylase
- Urinalysis
8
Q
What are the surgical treatments for perforated viscus?
A
- Laparotomy with complete exploration of the GI tract
- Colostomy/ileostomy
- Decontamination of spilled contents with repair of perforated site
- Endoscopic clips
- Percutaneous drainage of abscesses
9
Q
What are the pharmacological treatments for perforated viscus?
A
- Antibiotics
- Fluids
- Oxygen
10
Q
What are the non pharmacological treatments for perforated viscus?
A
Non as MEDICAL EMERGENCY
