Perforated Peptic Ulcer

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Perforated Peptic Ulcer

Symptoms

  • upper abdominal peritonitis
  • free gas under the diaphragm

Management

  • nasogastric tube
  • IV fluids
    • 500ml/1hr
  • bloods
    • amylase
    • group and save
  • CXR
    • erect good for seeing gas under diaphragm
  • ECG
  • Antibiotics
    • ceftriaxone and metronidazole
  • Analgesia
    • pethidine 100mg
  • Heparin 5000U / Clexane 20mg
  • TEDS
  • Ranitidine 50mg TDS
  • Catheter
  • ABGs
  • O2
  • For Theatres
    • Informed consent
    • Theatre booking and timing
    • oversewing
 

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