A young female with duodenal perforation

A female aged 38 years Chief Complaints Pain Abdomen Fever with chills Non passage of Flatus n Faeces (x 2 days) Physical Examination P/A- Distended, Tender, BS(-) Investigations UGIE - What can be seen?

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A case of duodenal ulcer of second part of duodenum perforation with with peritonitis may biliary peritonitis as the bile drains in the second part of duodenum leading to paralytic ileus leading to stoppage of stool and flatus. Pt need urgent attention as it may lead to septicaemic Needs urgent laparotomy with repair of perforation and good peritoneal lavage Post operative care as usual but with higher antibiotic.

Thanks Dr Shivraj Agarwal.
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Perforation of duodenal ulcer leading to peritonitis and ileus as bowel sounds are not heard Pt will need surgical intervention Gasterojejunostomy After pt is stable

Thanx dr Praveen Yograj sir
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A case of duodenal ulcer perforation in second part of duodenum with spreading peritonitis. An Exploratory laparetomy- followed by closure of perforation by 2- zero vicryl is indicated

no indication of performing endoscopy in this patient...simple chest erect xray mostly suffice

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