A perforation of the GI endothelium extending through the visceral wall into the peritoneal cavity, allowing GI contents to enter the peritoneum. Leakage can result in bacterial and/...
A ruptured bowel with peritonitis is a surgical emergency.
A workup should not delay definitive treatment in the setting of peritonitis.
Abdominal pain: often sudden onset or afte...
Admit to hospital.
Crystalloid fluid resuscitation to achieve early goal-directed therapy if the patient is in septic shock
Mean arterial pressure: >65 mm Hg
Urine outp...
Peptic ulcer disease
Compliance with acid-reducing medications
If ulcers do not heal, consider Zollinger-Ellison syndrome or malignancy; repeat endoscopy.
Diverticul...
Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg. 2010;27(3):161–169.
Kloss BT, Broton CE, Sullivan AM. Perforated Meckel div...
K63.1 Perforation of intestine (nontraumatic)
K26.5 Chronic or unspecified duodenal ulcer with perforation
K35.2 Acute appendicitis with generalized peritonitis
K57.20 Diverticulitis of large ...
Bowel perforation is often a clinical diagnosis.
A high index of suspicion in patients at the extremes of age and patients with multiple comorbidities avoids delays in diagnosis and tre...
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