Air shown in distended small intestine due to gut perforation (CASE1)

diagnosis? = generalised peritonitis

you should also take an erect chest x-ray to check for air underneath diaphragm which would back up this claim of bowel perforation

treatment? = quickly taken to OR, hole must be found and patched up

the stomach will feel very hard like a table, patients cannot deal with it and will be guarding, take AXR AND ERECT CXR

CASE 2

A 47 year old woman is admitted with a 3 day history of vomiting and colicky abdominal pain. The only previous history is of an appendicectomy 8years ago; she is otherwise fit and well. On examination she is dehydrated and has a distended abdomen that is tender centrally on palpation. An abdominal x-ray is requested (see next page).

THE LINES ACROSS THE SMALL BOWEL = VALVULAR CIRCULARIS which is indicative of a bowel obstruction

stethescope on stomach = specific high pitch tingling bowel sounds = additional hallmark sign of bowel obstruction

most common underlying causes?

hernia (organs through a wall in a place they aren’t meant to be)

Adhesion of contents (could be after surgery scarring or could be due to a tumour growth)