Perforated Peptic Ulcer

• What are the signs & symptoms of perforated peptic ulcer?

  Abdo pain & distension

  Nausea & vomiting

  Dyspepsia

  Constipation

  Shoulder tip pain (Kehr's sign)

  Abdo tenderness

  Peritonitis (guarding, rebound tenderness)

  Fever

  Tachycardia
• What are the Inx for perforated peptic ulcer?

  Obs

  Full Hx & examination

  Urine microscopy, culture & sensitivity

  Bloods (FBC, U&Es, LFTs, amylase/lipase)

  CXR

  CT abdo
• What is the management of a perforated peptic ulcer?

  IV fluids

  NG tube

  IV PPIs

  Abx

  Possible surgery

  OGD after 2-8 wks (treat H.pylori if needed)
• What are the possible complications of a perforated peptic ulcer?

  Sepsis

  Haemorrhage

  Post-operative leakage