An associated history of nonsteroidal anti-inflammatory drug (NSAID) consumption may be present. Patients of duodenal ulcer perforation usually have a short history of epigastric pain along with generalized tenderness and guarding. The clinical presentation of the patients varies according to the site of perforation. in their study of 504 consecutive cases.Ĭommon signs and symptoms are abdominal pain, vomiting, abdominal distension, constipation, fever, diarrhea, tachycardia (pulse >110/min), hypotension (systolic blood pressure 20/min). Similar results were seen by Jhobta et al. in their study of 400 patients found that the commonest cause of perforation peritonitis in their study was acid peptic disease (45%), followed by appendicitis (18.5%), typhoid fever (12%), tuberculosis (10%), and trauma (9%). The causes of pneumoperitoneum in children are perforation (necrotizing enterocolitis, Hirschsprung's disease, and meconium ileus) and iatrogenic effects, such as from use of rectal thermometer, enema, and postintubation or mechanical ventilation.īali et al.
Sometimes pneumomediastinum and pneumothorax may also result in pneumoperitoneum.
Mechanical perforation may be seen after colonoscopy, endoscopy, etc. The causes of pneumoperitoneum in adults are perforation, peritoneal dialysis, immediate postoperative status, vaginal aspiration, and mechanical ventilation. Urachus sign - Outline of middle umbilical ligament.Ī gastrointestinal perforation constitutes one of the commonest surgical emergencies.
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