The data reflects that early presentation to hospital and early treatment causes less morbidity and mortality. Patient who presented after 48 hrs. [jemds.com]

About one-third of cases of gastroduodenal perforation do not present with pneumoperitoneum on abdominal radiographs. [radiologykey.com]

Results: 50 patients studied with age range 18-60 years with mean age of presentation 36.80 years and mortality rate was 16%. Majority of cases were male 88%. [scopemed.org]

That is why the clinical presentation of posterior gastric perforation is less dramatic than that of the more common anterior perforations and is characterized by late presentation. [ejs.eg.net]

Articles are presented in an easy-to-digest and concisely worded format. Elsevier's Clinics Collections provide concise reviews of today's most prevalent conditions and significant medical developments. [books.google.com]

• Fever

  FAS-GIP protocol has especial usefulness in resource-poor environments, where ultrasound becomes the imaging tool of choice, especially in epidemic areas of the Typhoid Fever with a high frequency of intestinal perforation. [sonomir.wordpress.com]

  Later symptoms include fever and or chills. [6] In any case, the abdomen becomes rigid with tenderness and rebound tenderness. After some time the abdomen becomes silent and heart sounds can be heard all over. [en.wikipedia.org]

  SIGNS AND SYMPTOMS IN CASES IN % PAIN ABDOMEN 30 100% VOMITING 20 66.6% FEVER 10 33.3% DISTENSION ABDOMEN 20 66.6% GUADING & RIGIDITY 23 76.6% CONSTIPATION 03 10% SHOCK 13 43.3% MODS 07 23.3% TABLE 4: SYMPTOMS AND SIGNS Pain abdomen is the most common [jemds.com]

  This was accompanied by low grade fever and constipation. He never had similar problems in past. He was diagnosed with psoriasis and was on methyl prednisolone 20 mg per day for last three months. [casereports.in]

  Endoscopic gastroduodenal perforations are suspected when fever, tachycardia, or abdominal tenderness is present after the procedure. [sites.google.com]

• Pallor

  General physical examination showed conscious, alert, co-operative male having mild pallor and fever of 101°F. He was having exfoliative erythematous skin lesions over most of his body parts which was diagnosed as psoriasis previously [Fig.1,2]. [casereports.in]

  食道損傷 esophageal perforation食道穿孔 esophageal varices食道静脈瘤 esophagitis食道炎 esophagography食道造影 excretory duct導管 exocrine gland外分泌腺 external biliary fistula外胆汁瘻 extracorporeal shock wave lithotripsy (ESWL)体外衝撃波結石破砕術（ESWL） extrahepatic bile duct肝外胆管 f facial pallor [tokyo-med.ac.jp]

• Abdominal Pain

  Vague abdominal pain was the most common symptom. Exploration was delayed in six patients because of an absence of physical findings. All patients received a Graham omental patch. [ncbi.nlm.nih.gov]

  Discussion Abdominal pain frequently accompanies sickle cell pain crisis, in which vaso-occlusive or infarctive crisis often leads to acute abdominal pain associated with ischemia and infarction. [panafrican-med-journal.com]

  Applying the FAS-GIP protocol in all patients with unexplained abdominal pain allows me to stratify patients with an undifferentiated acute abdomen and prompt definitive diagnosis of gastro-intestinal perforation. FAS-GIP Protocol Download [sonomir.wordpress.com]

  In intestinal perforation, pain starts from the site of perforation and spreads across the abdomen. Gastrointestinal perforation results in severe abdominal pain intensified by movement, nausea, vomiting and hematemesis. [en.wikipedia.org]

• Vomiting

  SIGNS AND SYMPTOMS IN CASES IN % PAIN ABDOMEN 30 100% VOMITING 20 66.6% FEVER 10 33.3% DISTENSION ABDOMEN 20 66.6% GUADING & RIGIDITY 23 76.6% CONSTIPATION 03 10% SHOCK 13 43.3% MODS 07 23.3% TABLE 4: SYMPTOMS AND SIGNS Pain abdomen is the most common [jemds.com]

  In all types of perforation, nausea, vomiting, and anorexia are common. Bowel sounds are quiet to absent. [merckmanuals.com]

  Patients who vomit fresh blood or are in shock may have ongoing massive blood loss and should undergo endoscopy once they are resuscitated. [surgwiki.com]

  Dark, tarry bowel movements or vomiting material that resembles coffee grounds may signal bleeding from a peptic ulcer. Seek medical evaluation as soon as possible if you experience symptoms that might indicate a peptic ulcer. [livestrong.com]

  There may be the case where symptom of nausea or vomiting comes up. Medical check-up when preceding inflammation symptom comes up. When gastric and duodenal ulcer is suspected by the symptom, endoscopic exam is needed. [tokushukai.or.jp]

• Acute Abdomen

  The finding of pneumoperitoneum may allow for a definitive diagnosis at the bedside within minutes for the patient with an acute abdomen. Prompt diagnosis will facilitate correct management planning and a prompt operative procedure. [sonomir.wordpress.com]

  Some Causes of GI Tract Perforation Symptoms and Signs Esophageal, gastric, and duodenal perforation tends to manifest suddenly and catastrophically, with abrupt onset of acute abdomen with severe generalized abdominal pain, tenderness, and peritoneal [merckmanuals.com]

  Abdominal pain is frequently observed during vaso-occlusive or infarctive crisis and may lead to acute surgical abdomen [ 7, 8 ]. [panafrican-med-journal.com]

  "Gastrointestinal perforation and the acute abdomen". The Medical Clinics of North America. 92 (3): 599–625, viii–ix. doi : 10.1016/j.mcna.2007.12.004. [en.wikipedia.org]

  […] of life-threatening conditions in patients with acute abdomen. [criticalultrasoundjournal.springeropen.com]

• Nausea

  In all types of perforation, nausea, vomiting, and anorexia are common. Bowel sounds are quiet to absent. [merckmanuals.com]

  There may be the case where symptom of nausea or vomiting comes up. Medical check-up when preceding inflammation symptom comes up. When gastric and duodenal ulcer is suspected by the symptom, endoscopic exam is needed. [tokushukai.or.jp]

  Gastrointestinal perforation results in severe abdominal pain intensified by movement, nausea, vomiting and hematemesis. Later symptoms include fever and or chills. [6] In any case, the abdomen becomes rigid with tenderness and rebound tenderness. [en.wikipedia.org]

  The pain is typically exacerbated by food; nausea, unremitting pain and weight loss are common. Differentiation from duodenal ulcer (and gastric cancer) is unreliable. [surgwiki.com]

  Karger AG, Basel History For thousands of years healthy people have had acute abdominal pain, nausea, vomiting and diarrhea followed by death in a few hours or days. [karger.com]

• Epigastric Pain

  It was noted that patients who presented with epigastric pain were less likely to perforate than those without epigastric pain. The use of NSAIDs for at least one week and number of meals per day were not associated with perforation. [ihi.eprints.org]

  The authors suggest that patients receiving 5-FU infusion and cisplatin with dexamethasone for antiemesis who complain of epigastric pain should be mentioned for a gastroduodenal ulcer or even a perforation. [ncbi.nlm.nih.gov]

  The typical symptoms are epigastric pain like hunger or a painful cramp with no irradiation, punctuated by meals (with a pain-free interval lasting 1-3 h). [em-consulte.com]

  Lee et al. [ 9 ] investigated upper endoscopic and gastric acid output in 51 patients with homozygous sickle cell disease and recurrent epigastric pain. [panafrican-med-journal.com]

  Clinical features As in duodenal ulceration the usual presentation is epigastric pain. The pain is typically exacerbated by food; nausea, unremitting pain and weight loss are common. [surgwiki.com]

• Ulcer

  Abstract Elevated serum amylase is a frequent concomitant of perforated gastroduodenal ulcer. [ncbi.nlm.nih.gov]

  […] and peptic ulcers. [1] It is now well established that most peptic ulcers occur as a result of H. pylori infection. [mjdrdypu.org]

  Epidemiological analysis and use of rapid urease test in patients with perforated peptic ulcers. Rev Col Bras Cir. 2012;39(2):93-8. Behrman SW. Management of complicated peptic ulcer disease. Arch Surg. 2005;140(2):201-8. [msjonline.org]

• Irritability

  […] bowel syndrome (irritable colon syndrome)過敏性腸症候群 irritable colon刺激性結腸 j jaundice (icterus)黄疸 jejunum空腸 k ketone bodyケトン体 ketone groupケトン基 l lamina muscularis mucosae粘膜筋板 laparoscope (peritoneoscope)腹腔鏡 laparoscopic cholecystectomy (lapcholy)腹腔鏡下胆嚢摘出術 [tokyo-med.ac.jp]

  Irritated, inflamed skin around the tube is treated with "no-sting" skin sealant or a skin barrier cream. [sites.google.com]

  This is probably due to the dilution of the irritating gastroduodenal contents by ensuing peritoneal exudates. Phase 3: Intra-abdominal infection. After 12–24 h intra-abdominal infection supervenes. [karger.com]

  Patients with gastroduodenal perforation usually present with abdominal pain and peritoneal irritation from leakage of acidic gastric contents. [wjes.biomedcentral.com]

Victims of penetrating trauma with signs of peritonitis require surgical exploration without further diagnostic workup. [wjes.biomedcentral.com]

• Leukocytosis

  Laboratory tests are usually nonspecific, but leukocytosis, metabolic acidosis, and hyperamylasemia may be indicative of the presence of perforation. [radiologykey.com]

  Antibiotic Therapy Initial fistula management also includes appropriate broad-spectrum intravenous antibiotic therapy for those with tachycardia, leukocytosis, or cellulitis. [sites.google.com]

  In blood analysis a moderate leukocytosis will be found. The main reason for taking a blood sample is excluding other diagnoses like pancreatitis [ 4 ]. [karger.com]

  Laboratory studies are not useful in the acute setting as they tend to be nonspecific, but leukocytosis, metabolic acidosis, and elevated serum amylase may be associated with perforation [ 38 ]. [wjes.biomedcentral.com]

Abstract The purpose of this study was to evaluate the risk factors influencing the short-term results of gastroduodenal perforation to determine the optimal treatment for reducing mortality. [ncbi.nlm.nih.gov]

[…] of acid hypersecretion as well as the recognition and treatment of Helicobacter pylori. [utah.pure.elsevier.com]

four cases showed remission of symptoms in 24 hours or less after treatment, while one case showed no improvement of the symptoms, necessitating surgery 24 hours after treatment, although the postoperative course was uneventful. [jlc.jst.go.jp]

Lijecnicki Vjesnik 74(9-10): 197-200, 1952 The surgical treatment of gastroduodenal ulcers complicated by perforation and hemorrhage. Vestnik Khirurgii Imeni I. I. [eurekamag.com]

[…] of chapters throughout allows readers to easily scan through for the information required Useful summary boxes outline the main points of each condition including aetiology, pathology, epidemiology, clinical features, investigations, management and prognosis [books.google.com]

Trends in perforated peptic ulcer: Incidence, etiology, treatment, and prognosis. World J Surg. 2000;24(3):277-83. Kenneth T, Glomsaker TB, von Meer A, Søreide K and Søreide JA. [msjonline.org]

[…] colon cancer, diverticulitis, stomach ulcers, ischemic bowel, C. difficile infection [2] Diagnostic method CT scan, plain X-ray [2] Treatment Emergency surgery in the form of an exploratory laparotomy [2] Medication Intravenous fluids, antibiotics [2] Prognosis [en.wikipedia.org]

There is no clear cut definition for size of ulcer perforation even though the size less than 2.5cm carries good prognosis by simple closure with omental patch [14]. In our study, we have not come across giant perforation. [ispub.com]

Trends in Perforated Peptic Ulcer: Incidence, Etiology, Treatment, and Prognosis. World J Surg 2000;24:277-83. 6. Ng EK, Lam YH, Sung JJ, Yung MY, To KF, Chan AC, et al. [mjdrdypu.org]

All appeared to be statistical if not etiological associates of abnormal serum amylase levels. Because high amylase values so often occur in perforated ulcer, there is no amylase level that can be considered diagnostic of acute pancreatitis. [ncbi.nlm.nih.gov]

They also aid in the etiological diagnosis; location of all these signs guides toward the area of digestive perforation. [em-consulte.com]

The specific etiology of a gastric perforation may be difficult to determine because infants are usually sick and actual pathology yields few clues. Most gastric perforations are due to iatrogenic trauma. [latunisiemedicale.com]

[…] understanding whilst avoid unnecessary detail thus saving time Uniform style of chapters throughout allows readers to easily scan through for the information required Useful summary boxes outline the main points of each condition including aetiology, pathology, epidemiology [books.google.com]

Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]

Epidemiological analysis and use of rapid urease test in patients with perforated peptic ulcers. Rev Col Bras Cir. 2012;39(2):93-8. Behrman SW. Management of complicated peptic ulcer disease. Arch Surg. 2005;140(2):201-8. [msjonline.org]

Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion 2011; 84:102-113. 4. Williams N, Bullstrode C, Connell RO. [ejs.eg.net]

Helicobacter Pylori Epidemiology and Modes of Transmission. J Gastroenterol 2000;22:283-97. 5. Svanes C. Trends in Perforated Peptic Ulcer: Incidence, Etiology, Treatment, and Prognosis. World J Surg 2000;24:277-83. 6. [mjdrdypu.org]

The possible reasons for the high mortality and morbidity rates at that time may have been related to the following factors: Knowledge in the area of bowel injuries and the pathophysiologic changes triggered by such injuries was inadequate Clinical skills [emedicine.medscape.com]

The management of patients with peptic gastroduodenal ulcer disease should include counseling on risk factors and maintaining medications to prevent complications such as perforation. [ihi.eprints.org]

Completely revised and updated with 80 all-new chapters covering the most important information on current diagnostic, treatment, and preventive challenges facing feline practitioners today, Consultations in Feline Internal Medicine is an invaluable addition [books.google.com]

Opinions vary concerning the optimum treatment of acute gastroduodenal peptic perforation. 4,6,7,9,10,11,13,15,16,19,20 Not only does one have to consider the treatment of the acute abdominal catastrophe, but one should also bear in mind the prevention [jamanetwork.com]

Early diagnosis and treatment typically prevents the development of a perforation. Emergency medical evaluation and treatment are necessary if you experience any signs or symptoms that could signal a perforated ulcer. [livestrong.com]