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Pneumoperitoneum is pneumatosis (abnormal presence of air or other gas) in the peritoneal cavity, a potential space within the abdominal cavity.The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma.
A diagnosis of peritonitis is based primarily on the clinical manifestations described above. Rigidity (involuntary contraction of the abdominal muscles) is the most specific exam finding for diagnosing peritonitis. [14] If focal peritonitis is detected, further work-up should be done.
The sign indicates aggravation of the parietal peritoneum by stretching or moving. Positive Blumberg's sign is indicative of peritonitis, [3] which can occur in diseases like appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower quadrant.
Heel tap sign, also called heel-jar or jar tenderness, is a clinical sign to identify appendicitis.It is found in patients with localized peritonitis.With the patient supine the right heel is elevated by 10-20 degrees is hit firmly with palm of the examiner's hand.
It is found in patients with localised peritonitis due to acute appendicitis. [1] It is similar to rebound tenderness, but may be easier to elicit when the patient has firm abdominal wall muscles. Abdominal pain on walking or running is an equivalent sign. [2]
Sepsis, peritonitis, fistula [1] [2] Causes: Gynecological surgery, abdominal surgery, pelvic infection, appendicitis, inflammatory bowel disease [1] Diagnostic method: Blood tests, urine pregnancy test, blood and exudate culture, vaginal wet mount, medical imaging [1] Differential diagnosis
White blood cells and blood lactate levels may also be elevated, particularly in the case of advanced disease including peritonitis and sepsis. [20] Differential diagnoses of gastrointestinal perforation includes other causes of an acute abdomen, including appendicitis, diverticulitis, ruptured ovarian cyst, or pancreatitis. [21]
A differential diagnosis is also commonly used within the field of psychiatry/psychology, where two different diagnoses can be attached to a patient who is exhibiting symptoms that could fit into either diagnosis. For example, a patient who has been diagnosed with bipolar disorder may also be given a differential diagnosis of borderline ...