A male aged 48 years came to emergency with complaints of Pain abdomen and Obstipation since 1 day....On Examination, there was absence of bowel sounds and tenderness in epigastric region...vomment on the abdominal xray of the patient and discuss the findings
Radiologists opinion regarding X- ray is helpful. Widened mediastinum . Domes of diaphragm significantly raised. Splaying of trachea and left bronchus is clearly splayed . Multiple gaseous shadows in gut . Gas under right dome is doubtful. Evidence of paralytic ileus It looks like an interesting case . Needs,an urgent MRI before proceeding for Exploratory laparotomy
There is grossly dilated colon, with grossly dilated ileal loops and few jejunal dilated loops seen And there is absence of bowel sound which suggest Paralytic ileus causing generalised dilatation of colon and small intestinal loops causes can be multiple Perforated intestine Ischaemic bowel disease Electrolyte imbalance Spinal pathology CT scan abdomen and pelvis with oral and IV contrast would give more information on diagnosis
A strip of gas under rt dome Paralysed loops Suggest perforation Most likely peptic ulcer perforation Sos appendicular
Gas under the diaphragm May be peptic perforation leading to peritonitis and paralytic ileus.
POSSIBLY... PERFORATION WITH PERITONITIS.... ADVISABLE.... 1. C. T. SCAN.....WHOLE. ABDOMEN... 2. ALL. ROUTINE. INVESTIGATIONS 3. BLOOD. AND. URINE....C /S
Diaphragm seems to be pushed up.dilated and distended bowel loops.doubtful gas under diaphragm.could be adynamic ileus secondary to a bowel perforation.
Gas under diaphragm, most PROBABLY a case of perforation with peritonitis. URGENT surgery needed
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