- Can be complication of PUD
- Abrupt severe, generalized abdominal pain
- GI content spills into peritoneum > chemical then bacterial peritonitis
- Rigid abdomen, peritonitis (not always seen in older patients)
ABC, 2 large-bore IVs, O2, Monitor,
Basic labs + type and screen
NG tube with suction
Abdominal series Xray to assess for free air (not always visible)
Broad spectrum Abx (including anaerobic coverage)
Sometimes patients are stable enough to CT which often reveals dx
Operative intervention is standard of care.
- Angela M. Bogle and Matthew C. Gratton. “Chapter 78: Peptic Ulcer Disease and Gastritis.” In Tintinalli, Judith E., et al. a Comprehensive Study Guide. McGraw-Hill, 2016.