Gas in the abdomen
An eighty-year-old man came with abdominal pain and vomiting for a week. Examination shows a dehydrated patient with abdominal distension and tenderness; it was most painful at the right upper quarter of the abdomen.
An abdominal X-ray taken supine (lying down) looks like this:
It shows the intestines crowded to the left side and the outlines of the intestines can be seen clearly…. too clearly.
And if you look on the right side.. there’s a stone on the X-ray. Based on the location, it’s a gallbladder stone.
So what’s going on here? This:
There’s gas in the abdominal cavity
It’s completely normal to have gas in the intestines. But gas should not be in the abdominal cavity outside of the intestines. It means that somewhere along the stomach or intestines, gas has leaked out.
Now, that’s dangerous. The gas is not dangerous… it’s the other material that leak with the gas that’s dangerous. It means that the contents of the stomach or intestines have leaked out to the abdominal cavity. These are full of bacteria, stomach acid, bile and enzymes. They can kill.
This means that the patient needs urgent surgery to identify the leak and repair it. This was found to be a leaking stomach ulcer. It was repaired and the leaking material was washed out. The gallbladder and the stone inside it were removed as well.
leaking caused peritonitis?
any gory pictures of this to share doc?
oh my! 80 yrs old, isn’t it a little risky to go for surgery? How did it happen? So scary….
Err.. I’m not very good at this, and I’m not sure about your other readers, but I was wondering whether you could, you know, mark the spots that you’re talking about (with a red circle or something like that)?? Because I don’t seem to see the “obvious” intestine outlines?
Wow, I feel physically relieved just reading that. I bet the patient is feeling great and doing cartwheels! Thank you for saving yet another human life Bernard. *high five* Stomach ulcers are nothing to ignore.
A great ID there, Bernard with the picture.
Wah. That is scarey. If I keep visiting you and Eve I am so going to become a hypocondriac. lol!
I don’t know how you see the stone and the abdominal cavity outlines from the X-ray. Can mark it and show, please?
80 year old?
The recovery … I don’t want to imagine…
Kat, perforated gatric ulcer.
Sarah, my camera batteries went dead, hence the bland x-ray images only..
eastcoastlife, well. age is not the factor.. the general fitness is. He actually had a number of pre-existing cardiac and respiratory conditions as well… but it’s either do or ***
pelf, oh yes.. sorry about that, i was in a hurry.. lemme mark the x-rays and post up.
Annie, definitely not something to ignore.
Capt Picard, huh?
Simple American, … visit George too.. that’ll complete the picture. Haha.
jonzz, ok. will do.
yenjai, yup.. tough. Going to take a lot of motivating.