c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Perforated Ulcer: 1

A D V E R T I S E M E N T

   
 

A 58-year-old woman presented to the emergency room with a history of 4 days of dark loose stool and a 24-hr history of worsening abdominal pain. There was no history of prior abdominal surgery or ulcer disease. On abdominal exam there was diffuse 3+ tenderness, guarding and 1+ rebound. Bowel sounds were hypoactive. She was afebrile, WBC was 13K without a shift. Hemoglobin and hematocrit were low normal. Her normal abdominal upright film is shown.     

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Perforated Ulcer: 2

A D V E R T I S E M E N T

   
 

Upright chest X-ray showed no free subphrenic air.       

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Perforated Ulcer: 3

A D V E R T I S E M E N T

   

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The patient was taken for CT scan of the abdomen. There were bubbles of free air around the first portion of the duodenum and inferior vena cava.     

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This page was last modified on 8/18/2008.