Gastrointestinal perforation physical examination

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

Overview

Patients may appear tired, weak, diaphoretic and anxious especially if sepsis developed.
Immunocompromised patients may appear quite well at first.

Asymmetric chest expansion/ decreased chest expansion in esophageal perforation patients^[2]

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]

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]

↑ ^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.