Gastrointestinal perforation physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Overview

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
• Hypotension occurs due to fluid contraction

Skin

• Jaundice secondary to deranged liver function if sepsis developed.

Head

• Scleral icterus in case of liver failure

Lungs

• Asymmetric chest expansion/ decreased chest expansion in esophageal perforation patients

Heart

• Chest tenderness in esophageal perforation patients

Abdomen

• Abdominal distention 
• Abdominal tenderness
• A palpable abdominal mass in the lower abdominal quadrant especially with perforated colon
• Guarding may be present
• Cutaneous fistula may be present