Patient is on autocoids for 1 year complains of severe pain epigasrium relieved iv antacids now complains of pain in right iliac fossa and epigastrium with fever and loss of liver dullness diagnosis -
Ans. is 'a' i.e., Duodenal perforation * Long term therapy with autocoids led to an ulcer that eventually perforated and now the patient has presented early signs of peritonitisClinical features of perforation of duodenal ulcer* Perforated duodenal ulcer is characterized by sever constant onset epogastric pain* Patient looks ill and lies unusually still* Tachycardia* Shallow respiration* Tender with intense guarding and rigidity* If the air has escaped into peritoneal cavity then liver dullness may be absent* Peptic ulcer perforation leads to chemical peritonitis initially. Thus in the first 24 hours, the patient does not show signs of general toxicity. After this period bacterial peritonitis sets in.
Duodenal perforation
Diverticulitis
Gastroenteritis
Enteric perforation
Stomach & Duodenum