Sunday, December 22, 2013

Clinical Feature and the Treatment of Perforated Peptic Ulcer Diseases


Peptic Ulcer disease is a condition when excessive acid pepsin condition makes a foramen (perforation) in the gas containing hollow viscous of the abdomen.

Clinical feature of perforated peptic ulcer disease

1.       History of previous peptic ulcer disease and non steroidal anti inflammatory drug (NSAIDs) intake.
PUD perforation
2.       Abdominal pain; which is sudden in onset, severe in intensity. The distribution of the pain follows the spread of the gastric contents over the peritoneum. Pain initially develops on the upper abdomen and rapidly become generalized. Pain is also being felt on the tip of the shoulder due to the irritation of the diaphragm. The pain is accompanied by shallow respiration due to limitation of the diaphragmatic movement and by shock.
3.       The muscle of the abdomen become board like rigid.
4.       Bowel sounds are not audible.

5.       Liver dullness to percussion decreases due to the presence of gas under the diaphragm.
6.       Features of shock, such as tachycardia and low blood pressure and rapid thin thread pulse can be found.

Investigations

1.       Plain X ray of the abdomen in erect posture, showing both domes of the diaphragm, anterior-posterior view.
2.       Serum electrolytes.
3.       Ultrasonography of the whole abdomen.
4.       Estimation of the blood urea level.
5.       Water soluble contrast swallow will confirm the leakage of the gastrodeodenal content. 

Treatment

Immediate resuscitation of the patient. Nothing per oral is given. A ryles tube is inserted and gastric content can be aspirated to ensure gastric decompression.

Intravenous fluid is start to recover the patient from shock and correct the dehydration. Antibiotic is start in the parenteral route. After proper resuscitation surgical correction of the perforation is done under general anesthesia by making an upper midline incision.  

3 comments:

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    I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulate all over my body and i have been taking treatment from my doctor, few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr Gumbla and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so i wrote to Dr Gumbla telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as the Dr assured me that i have cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So friends my advise is if you have such sickness or any other at all you can email Dr Gumbla on : (greatgumblaspellhome@outlook.com) or thought his website http://eromosalspiritualtemple.webs.com or call or what'sapp him with +2348161850195.. THESE ARE THE THINGS DR GUMBALA CAN
    ALSO CURE.. GONORRHEA, HIV/AIDS , LOW SPERM COUNT, MENOPAUSE DISEASE, PREGNANCY PROBLEM, SHORT SIGHTEDNESS PROBLEM, Stroke, Bring back ex lover or wife/husband....sir i am indeed grateful for the help i will forever recommend you to my friends!!!

    ReplyDelete
  2. I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulate all over my body and i have been taking treatment from my doctor, few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr Gumbla and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so i wrote to Dr Gumbla telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as the Dr assured me that i have cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So friends my advise is if you have such sickness or any other at all you can email Dr Gumbla on : (greatgumblaspellhome@outlook.com) or thought his website http://eromosalspiritualtemple.webs.com or call or what'sapp him with +2348161850195.. THESE ARE THE THINGS DR GUMBALA CAN
    ALSO CURE.. GONORRHEA, HIV/AIDS , LOW SPERM COUNT, MENOPAUSE DISEASE, PREGNANCY PROBLEM, SHORT SIGHTEDNESS PROBLEM, Stroke, Bring back ex lover or wife/husband....sir i am indeed grateful for the help i will forever recommend you to my friends!!!

    ReplyDelete
  3. I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulate all over my body and i have been taking treatment from my doctor, few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr Gumbla and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so i wrote to Dr Gumbla telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as the Dr assured me that i have cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So friends my advise is if you have such sickness or any other at all you can email Dr Gumbla on : (greatgumblaspellhome@outlook.com) or thought his website http://eromosalspiritualtemple.webs.com or call or what'sapp him with +2348161850195.. THESE ARE THE THINGS DR GUMBALA CAN
    ALSO CURE.. GONORRHEA, HIV/AIDS , LOW SPERM COUNT, MENOPAUSE DISEASE, PREGNANCY PROBLEM, SHORT SIGHTEDNESS PROBLEM, Stroke, Bring back ex lover or wife/husband....sir i am indeed grateful for the help i will forever recommend you to my friends!!!

    ReplyDelete