User:Jpola3399/Gastrointestinal perforation

Diagnosis
A hole in the gastrointestinal tract causes leakage of gas into the abdominal cavity. In a patient with intestinal perforation, gas may be visible under the diaphragm on x-ray while the patient is in an upright position. While x-ray is a cheap and efficient way to screen for perforation, a CT scan is more sensitive and specific for establishing a diagnosis as well as determining the underlying cause.^citation A computerized tomography scan is ordered with contrast '

Complications: sepsis, peritonitis

Another diagnostic method is laparotomy.

Initial x-ray may appear normal.

The perforation can often be visualised using White blood cells are often elevated.

Treatment
Surgical intervention is nearly always required.

The goals of surgery

Remove dead tissue and close the hole

The death rate (mortality)

Surgical intervention is nearly always required. Exploratory laparotomy is often performed with closure of perforation and peritoneal wash. Exploratory laparoscopic surgery using surgical instruments and a camera through a few small keyhole incisions is another option for minimally invasive surgical management. A Graham patch may be used for duodenal perforations.

A drain may be placed to control any fluid collection.

All patients are placed on bowel rest (avoiding all food and fluids by mouth), intravenous fluids, and antibiotics.

Conservative treatment (avoiding surgery) may be sufficient in the case of a contained perforation. It is indicated only if the person has normal vital signs and is clinically stable.

, nasogastric aspiration

A CT scan showingg bowel obstruction