what is duodenal perforation treatment clinical feature and investigation .....

duodenal rupture due any cause is called duodenal perforation . it is an emergency condition

causes

          there is usually history of peptic ulcer 

     increase intake of NSAID 

clinical feature 

         there is epigistric pain 

        pain is usually sever and nature 

       there is nausea and vomiting

 

        abdomen is tender 

        there is rigidity in abdominal wall 

       feature of shock may be present 

patient looks toxic 

        blood preassure my be dropped 

investigation 

]]complete blood count  

      ]]    x ray abdomen 

]]]      in x ray there is usually gas under the diaphragam 

  ]]]     endoscopy ma be done 

   ]]] blood sugar may be checked 

treatment

                    ]] keep patient nil by mouth [NBM} 

                 ]]]]  pass iv cannula 

           ]]]]      give analgesics e g iv opeiod 

       ]]]      pass N/G tube and aspirate 

]]]]   inf ringer lactate d 1000  mi state then  BD 

]]]    metronidazol state [TDS } 

 ]]]    inf ciprofloxacine   or ceftraxsone [BD} 

]]]    laprotomy is done to close the perforation