Perforated Viscus

Question 1

what may cause a spontaneous perforation of an intra-abdo viscus?

Answer 1

• weakening of wall of viscus (after ischaemia, inflammation, infection)
• increased luminal pressure (closed loop obstruction)
• peptic ulcer
• acute appendicitis
• acute diverticulitis
• colon carcinoma
• IBD
• acute cholecystitis
• iatrogenic during surgery

Question 2

what are the clinical features of a perforated viscus?

Answer 2

• sudden onset of severe abdo pain
• well localised
• localised peritonitis (rebound tenderness)
• generalised peritonitis

Question 3

What are the signs and symptoms of peritonitis?

Answer 3

• sharp, constant pain
• guarding
• rebound tenderness
• if generalised peritonitis then entire abdo will be rigid due to gaurding
• pain on coughing or moving