Gastrointestinal perforation physical examination: Difference between revisions
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Revision as of 04:31, 4 February 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
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Overview
Gastrointestinal perforation physical examination
Appearance of the Patient
- Patients may appear tired, weak, diaphoretic and anxious especially if sepsis developed.
- Immunocompromised patients may appear quite well at first.
Vital Signs
- Tachycardia
- Rapid weak pulse[1]
- Hypotension occurs due to fluid contraction
Skin
Head
- Scleral icterus in case of liver failure
Lungs
Heart
- Chest tenderness in esophageal perforation patients[2]
Abdomen
- Abdominal distention[3]
- Abdominal tenderness[4]
- A palpable abdominal mass in the lower abdominal quadrant especially with perforated colon
- Guarding may be present[3]
- Cutaneous fistula may be present[4]
Presentation in neonatal perforation:
- Infants with spontaneous intestinal perforation (SIP) present with an acute onset of abdominal distension and hypotension.[5]
- Abdominal distention usually occurs without the abdominal wall erythema, crepitus, and induration commonly seen in patients with necrotitzing enterocolitis.
- A black-bluish discoloration of the abdominal wall is often seen in SIP, and is not typical of necrotitzing enterocolitis.[6]
References
- ↑ 1.0 1.1 Bankole AO, Osinowo AO, Adesanya AA (2017). "Predictive factors of management outcome in adult patients with mechanical intestinal obstruction". Niger Postgrad Med J. 24 (4): 217–223. doi:10.4103/npmj.npmj_143_17. PMID 29355160.
- ↑ 2.0 2.1 Neesgaard B, Sejling AS, Ostenfeld-Møller LA (2017). "[Upper abdominal pain caused by oesophageal perforation]". Ugeskr Laeger. 179 (45). PMID 29108538.
- ↑ 3.0 3.1 Devaraj NK (2017). "Letter to the Editor: Colonic Perforation". Acta Med Port. 30 (12): 891. doi:10.20344/amp.9556. PMID 29364805.
- ↑ 4.0 4.1 Rami Reddy SR, Cappell MS (2017). "A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction". Curr Gastroenterol Rep. 19 (6): 28. doi:10.1007/s11894-017-0566-9. PMID 28439845.
- ↑ Aschner JL, Deluga KS, Metlay LA, Emmens RW, Hendricks-Munoz KD (1988). "Spontaneous focal gastrointestinal perforation in very low birth weight infants". J Pediatr. 113 (2): 364–7. PMID 3397802.
- ↑ Adesanya OA, O'Shea TM, Turner CS, Amoroso RM, Morgan TM, Aschner JL (2005). "Intestinal perforation in very low birth weight infants: growth and neurodevelopment at 1 year of age". J Perinatol. 25 (9): 583–9. doi:10.1038/sj.jp.7211360. PMID 16034475.