{"id":19,"date":"2007-07-29T16:25:01","date_gmt":"2007-07-29T16:25:01","guid":{"rendered":"http:\/\/jha.in\/?p=18"},"modified":"2007-07-29T16:25:01","modified_gmt":"2007-07-29T16:25:01","slug":"a-case-of-intestinal-perforation","status":"publish","type":"post","link":"https:\/\/jha.in\/?p=19","title":{"rendered":"A Case of Intestinal Perforation"},"content":{"rendered":"<p>So this 24 year old is brought by his relatives and neighbours at 2.00 am on a hot muggy july night. He was having fever for last 15 days and complains of increasing pain in abdomen since last five days. He was looking worse than before so they brought him to the hospital emergency. The patient is obviously in pain with sweat covering his forehead holding his stomach. Look for his radial pulse; hardly palpable. His arms and legs are cold and clammy-of couse &#8211; he is in <a href=\"http:\/\/en.wikipedia.org\/wiki\/Shock_%28medical%29\">shock<\/a>. His abdomen is <a href=\"http:\/\/en.wikipedia.org\/wiki\/Peritonitis#Abdominal_pain_.26_tenderness\">tense and tender<\/a>. He is suffering from peritonitis and that is most likely due to perforation in his gut. X-ray of abdomen shows presence of free gas under the diaphragm confirming the clinical impression.<\/p>\n<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  <img decoding=\"async\" src=\"http:\/\/www.rcsed.ac.uk\/journal\/vol46_5\/4650045.jpg\" \/> &nbsp; &nbsp; &nbsp; &nbsp; <\/p>\n<p>&nbsp;This requires an urgent operation- a <a href=\"http:\/\/www.healthline.com\/galecontent\/laparotomy-exploratory?utm_term=laparotomy&amp;utm_medium=mw&amp;utm_campaign=article\">laparotomy<\/a>&nbsp; to repair the defect. So on to the operating table after <u>preparation<\/u><font color=\"#ffcc99\">&nbsp; <font color=\"#000000\">(will be subject of another post). Abdomen is full of gut content with foul smell. The mess is cleaned and peritoneal cavity washed with warm saline. Rent in the ileum is repaired and abdomen closed after inserting a drain. Keep fingers crossed in the post operative period as the patient recovers and improves in the next 4 to 5 days. A seemingly simple task with many a pitfalls successfully completed.&nbsp;<\/font> <\/font><br \/><a href=\"http:\/\/www.healthline.com\/galecontent\/laparotomy-exploratory?utm_term=laparotomy&amp;utm_medium=mw&amp;utm_campaign=article\"><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>So this 24 year old is brought by his relatives and neighbours at 2.00 am on a hot muggy july night. He was having fever for last 15 days and complains of increasing pain in abdomen since last five days. He was looking worse than before so they brought him to the hospital emergency. The [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-19","post","type-post","status-publish","format-standard","hentry","category-uncategorized","entry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>A Case of Intestinal Perforation<\/title>\n<meta name=\"description\" content=\"A Case of Intestinal Perforation\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jha.in\/?p=19\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A Case of Intestinal Perforation\" \/>\n<meta property=\"og:description\" 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