Acute abdomen with pneumoperitoneum without hollow viscus perforation

2021 ◽  
Author(s):  
Fahad Al Islam ◽  
Mark Muhlmann
Keyword(s):  
Acute Abdomen ◽  
Hollow Viscus ◽  
Hollow Viscus Perforation

scholarly journals An acute abdomen packed full of surprises: a case report

2019 ◽  
Vol 6 (4) ◽  
pp. 1424
Author(s):  
Ashwath Narayan Ramji
Keyword(s):  
Case Report ◽  
Acute Abdomen ◽  
Malignant Transformation ◽  
Clinical Diagnosis ◽  
Male Patient ◽  
Acute Diverticulitis ◽  
Final Diagnosis ◽  
Stricture Formation ◽  
Hollow Viscus ◽  
Hollow Viscus Perforation

“Acute abdomen” is a clinical diagnosis which defines the emergent nature of the condition, rather than the condition itself, and the true diagnosis is often only made after laparotomy or laparoscopy. On occasion, the final diagnosis is drastically different from what was clinically suspected. Diseases such as diverticulosis can have multiple possible pathological outcomes as a consequence of their inflammatory nature, such as stricture formation, adhesions, acute diverticulitis, diverticular abscess, perforation and even malignant transformation. Usually one of these complications will be the presenting factor with rarely another complication discovered during management, which may or may not have been symptomatic. Extremely rarely, will multiple pathological outcomes of a condition be present together. Here we report the case of a male patient who underwent laparotomy for a suspected hollow viscus perforation, with the resulting findings a bewildering surprise.

scholarly journals Comparative analysis of clinical, radiological and operative findings in acute abdomen

2019 ◽  
Vol 6 (3) ◽  
pp. 806
Author(s):  
Mir Zeeshan Ali ◽  
Vamsee Krishna Maddu
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Diagnostic Utility ◽  
Common Symptom ◽  
Care Hospital ◽  
Hollow Viscus ◽  
Hollow Viscus Perforation

Background: The term acute abdomen refers to signs and symptoms of abdominal pain and tenderness that often requires emergency surgical therapy. The objective of the present study is to compare pre-operative diagnosis based on clinical examination with the operative diagnosis in acute abdomen.Methods: Total 60 cases of acute abdomen who underwent laparotomy in a tertiary care hospital   were analysed prospectively regarding clinical features and also assessed the diagnostic utility of radiological investigations like plain abdominal radiographs, ultrasonography and computed tomography.Results: Acute abdomen was most common in males and 2nd to 5th decade of life. Appendicitis was most common cause of acute abdomen followed by hollow viscus perforation and intestinal obstruction. Abdominal pain was the most common symptom. Tenderness was the most common sign. Diagnostic utility of x-ray is more in hollow viscus perforation and intestinal obstruction, whereas ultrasonography is diagnostic in 64.3%. Ultrasonography accurately diagnosed acute appendicitis in 74.2%, hollow viscus perforation in 50%, and intestinal obstruction in 60% of patients. 95% clinical accuracy was found when compared to intra operative diagnosis. Kappa is 0.912 (p<0.0001).Conclusions: Clinical judgement is key to diagnosis of acute abdomen and investigations are only supplementary and cannot replace the clinical decision.

scholarly journals Clinical study and management of hollow viscus perforation of abdomen

2017 ◽  
Vol 4 (5) ◽  
pp. 1773
Author(s):  
Dhanapal Pattanam Velappan ◽  
Selvam Kaveri
Keyword(s):  
Acute Abdomen ◽  
Tamil Nadu ◽  
Signs And Symptoms ◽  
Gastrointestinal Perforation ◽  
High Morbidity ◽  
Hollow Viscus ◽  
College Hospital ◽  
Adequate Treatment ◽  
Abdominal Emergency ◽  
Hollow Viscus Perforation

Background: Gastrointestinal perforation is a common abdominal emergency having a high morbidity and mortality. Surgery plays an important role in the management of perforation. Gastrointestinal perforation is a common abdominal emergency having a high morbidity and mortality.Methods: 100 cases of hollow viscus perforation of the abdomen have been studied prospectively in detail during the period from May 2010 to July 2012. Cases were selected randomly from admissions in Government Mohankumaramangalam Medical College Hospital, Salem, Tamil Nadu, India. Clinical diagnosis of hollow viscus perforation confirmed by investigations or by laparotomy performed.Results: The results obtained in the present study were analysed: Among hollow viscus perforation duodenal ulcer perforation was common (52 out of 100 cases). Next being appendicular perforation. Age group of 20-40 years were affected mainly. Males are affected more than females. Signs and symptoms of acute abdomen like acute abdominal pain vomiting fever may present tachycardia, hypotension, abdominal tenderness guarding\rigidity with obliteration of liver dullness and absence of bowel sounds and absolute constipation were predominant signs.Conclusions: GI hollow viscus perforations cause significant morbidity and sometimes mortality. Hollow viscus perforation is the common cause of acute abdomen needing immediate effective surgical attention. A proper early diagnosis and adequate treatment can prevent complications. Surgical approach depends on the site, size, age of perforation and number of perforations.

scholarly journals Spontaneous perforated pyometra presenting as an acute abdomen: appraisal of three consecutive cases

2018 ◽  
Vol 21 (1) ◽  
pp. 37-38
Author(s):  
Pooja Paudyal ◽  
Josie Baral ◽  
Geeta Gurung ◽  
Ashma Rana ◽  
Suniti Rawal ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Acute Abdomen ◽  
Elderly Women ◽  
Histopathological Examination ◽  
Uterine Cavity ◽  
Uterine Perforation ◽  
Hollow Viscus ◽  
Chronic Endometritis ◽  
Purulent Fluid ◽  
Hollow Viscus Perforation

Introduction: Pyometra is the accumulation of purulent fluid in the uterine cavity caused by impaired drainage of pus due to benign or malignant conditions; rarely with resultant spontaneous uterine perforation brought about by uterine distension. Cases: We report three consecutive cases of spontaneous perforated pyometra in postmenopausal elderly women aged 60 to 70 years who presented with acute abdomen, initially diagnosed as hollow viscus perforation, demonstrated of having significant uterine perforation at laparotomy for which hysterectomy with bilateral salpingo-oophorectomy were done. Histopathological examination revealed features of necrosis of stroma with chronic endometritis without any evidence of malignancy in all the three cases. Conclusion: Spontaneous perforated pyometra, a grave complication necessitating prompt intervention, should always be kept as a possibility in all cases of suspected pyoperitoneum and acute abdomen in elderly postmenopausal women.

Anesthetic management of a patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Reza Widianto Sudjud ◽  
Djoni Kusumah Pohan ◽  
Muhammad Budi Kurniawan ◽  
Hana Nur Ramila
Keyword(s):  
Hemorrhagic Shock ◽  
Blunt Abdominal Trauma ◽  
Massive Transfusion ◽  
Damage Control ◽  
Anesthetic Management ◽  
Hollow Viscus ◽  
Permissive Hypotension ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol ◽  
Hollow Viscus Perforation

Hemorrhagic shock is a form of hypovolemic shock in which severe blood loss leads to inadequate oxygen delivery at the cellular level. Death from hemorrhage represents a substantial global problem, with more than 60,000 deaths per year in the United States and an estimated 1.9 million deaths per year worldwide, 1.5 million of which result from physical trauma. This case report aims to stress the need of handling cases of hemorrhagic shock in accordance with damage control protocol. Hemorrhagic shock management using permissive hypotension management, bleeding control, massive transfusion protocol (MTP), minimal crystalloid therapy, and adjuvant therapy is the best approach to get optimal outcome to prevent triad of death. In this case, the application of damage control resuscitation has not been fully implemented because of several constraints. Key words: Hemorrhage; Hemorrhagic shock; Permissive hypotension; Massive Transfusion Protocol; MTP; Resuscitation; Damage control Citation: Pohan DK, Sudjud RW, Kurniawan MB, Ramila HN. Anesthetic management on patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock. Anaesth. pain intensive care 2021;25(2):217-221. DOI: 10.35975/apic.v25i2.1474 Received: 11 January 2021, Reviewed: 15 January 2021, Accepted: 16 February 2021

scholarly journals Cas/Medevac in field area: An experience and lessons drawn

2019 ◽  
Vol 63 ◽  
pp. 33-38
Author(s):  
Murtaza ◽  
P Biswal
Keyword(s):  
United Nations ◽  
Medical Care ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical Establishment ◽  
Level Ii ◽  
Incremental Information ◽  
Standard Operating ◽  
Field Area ◽  
Hollow Viscus Perforation

Introduction: Success of Cas/Medevac missions depends on effective coordination between all agencies involved. The focus by medical authorities on the treatment and medical care at time leads to avoidable procedural complexity. Certain lessons are drawn from the United Nations (UNs) field areas for Cas/Medevac missions/laid down procedures and recommendations made for streamlining our own procedures. Materials and Methods: The data pertaining to Cas/Medevac details from IFH Level-II Malakal (UN Mission in South Sudan [UNMISS]) for January 2017 - February 2018 were collected and analyzed. Standard operating procedures (SOPs) followed in the UN field areas for Cas/Medevac missions were also studied and analyzed. Results and Discussion: A total of 19 cases were air evacuated from IFH Level-II UNMISS to higher medical establishments and 11 cases from periphery to IFH Level-II in 1 year plus period. Aeromedical issues involved are discussed here with emphasis on Medevac of patient with suspicion of hollow viscus perforation/pancreatitis. Procedures and documentation followed in the UN Medevac missions are discussed and suggestions made for improving Cas/ Medevac procedures in field areas. A sample of Cas/Medevac incremental information form is also suggested. Conclusion: Timely evacuation of a casualty to an appropriate medical establishment can reduce mortality and morbidity significantly. Experience of Cas/Medevac missions in the UN field area is presented in this paper along with analysis and discussion on SOPs followed in the UN mission areas. Suggestions are made to refine and streamline our own Cas/Medevac procedures in field areas and theaters of conflict.

scholarly journals Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.
Keyword(s):  
Perioperative Complications ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Threatening Condition ◽  
Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

scholarly journals Gastro intestinal perforations: an audit from a tertiary care teaching hospital, Mysore, India

2018 ◽  
Vol 5 (11) ◽  
pp. 3484
Author(s):  
Shashikumar H. B. ◽  
Madhu B. S. ◽  
Shyama S.
Keyword(s):  
Surgical Procedure ◽  
Dietary Habits ◽  
Tertiary Care ◽  
Patch Repair ◽  
Age Group ◽  
Hollow Viscus ◽  
Care Teaching ◽  
Presenting Symptoms ◽  
Intestinal Perforations ◽  
Hollow Viscus Perforation

Background: Peritonitis secondary to hollow viscus perforation is one of the most frequently encountered surgical emergencies in India. The objective of this study was to study the demographic and clinical profile of gastro intestinal perforations and surgical procedures done for the same in a tertiary care teaching hospital.Methods: This study was performed on 46 cases of hollow viscus perforation admitted in K. R. Hospital from January to June 2018. The presenting symptoms, age and sex profile, risk factors, site of perforation, the surgical procedure they underwent, post-operative complications were assessed and analyzed.Results: The most common age group affected was 21-30 years out of which 89.1 % were males. Gastric perforations were the most common type (56.5%) and jejunal perforations were the least common (6.5%). Abdominal pain was the main presenting symptom in all the cases. Fever was found to be a significant history in cases of ileal perforation (p=0.001) as was history of trauma in cases of jejunal perforation (p=0.001). Guarding, rigidity and air under the diaphragm were seen consistently in most cases. Graham’s patch repair was the most common surgical procedure performed. Ileostomy was the most common surgery done for ileal perforations. Wound infections were the most common post-operative complication observed and death occurred in 13% of cases mostly due to sepsis and cardio pulmonary complications.Conclusions: This study showed an increased incidence of perforation in younger age group which is alarming. The rise in the frequency of gastric perforations points towards an unhealthy lifestyle and dietary habits.

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