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Patients with perforated Valentino's syndrome usually present with a sudden onset of severe, sharp abdominal pain in the right lower quadrant (RLQ), that is similar to acute appendicitis. [4] Most patients describe generalized pain; a few present with severe epigastric pain, located in the upper abdominal area.
In severe cases with perforation, an adjacent phlegmon or abscess can be seen. Dense fluid layering in the pelvis can also result, related to either pus or enteric spillage . When patients are thin or younger, the relative absence of fat can make the appendix and surrounding fat stranding difficult to see.
In intestinal perforation, gas may be visible under the diaphragm on chest x-ray while the patient is in an upright position. While x-ray is a fast and inexpensive to screen for perforation, an abdominal CT scan with contrast is more sensitive and specific for establishing a diagnosis as well as determining the underlying cause. [19]
About 10% of cases have a more serious cause including gallbladder (gallstones or biliary dyskinesia) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%). [2] More common in those who are older, ischemic colitis, [5] mesenteric ischemia, and abdominal aortic aneurysms are other serious causes. [6]
Mechanical obstruction is the cause of about 5 to 15% of cases of severe abdominal pain of sudden onset requiring admission to hospital. [1] [2] Causes of bowel obstruction include adhesions, hernias, volvulus, endometriosis, inflammatory bowel disease, appendicitis, tumors, diverticulitis, ischemic bowel, tuberculosis and intussusception.
It is a descriptive term which may be used for inflammation related to a bacterial infection or non-infectious causes (e.g. pancreatitis). Most commonly, it is used in contradistinction to a "walled-off" pus-filled collection , although a phlegmon may progress to an abscess if untreated. A phlegmon can localize anywhere in the body. [1]
If properly treated, typical cases of surgically correctable peritonitis (e.g., perforated peptic ulcer, appendicitis, and diverticulitis) have a mortality rate of about <10% in otherwise healthy people. The mortality rate rises to 35% in peritonitis patients who develop sepsis, and patients who have underlying renal insufficiency and ...
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.