ACTION STAT: Perforated peptic ulcer

December 2004 
Volume 34  Number 12
Pages 88 - 88
  PDF Version Available!


  • What's the situation?

  • What's your assessment?

  • What must you do immediately?

  • What should be done later?


  • Figure. LYNN FELLMAN...

    CONSTRUCTION WORKER George Bennett, 42, arrives in the ED accompanied by his wife. He's diaphoretic, and he complains of sharp, severe upper abdominal pain that started suddenly about 45 minutes ago, increases with movement and breathing, and extends to his right shoulder. He says he frequently has indigestion, but it's never been this bad.

    You help Mr. Bennett onto a stretcher; he draws his knees up to his chest when he lies down. His BP is 140/86; apical pulse, 128; respirations, 36 and shallow; and temperature, 99° F (37.2° C). He denies any nausea or vomiting. His abdomen is rigid with generalized rebound tenderness. Bowel sounds are absent.

    What's the situation?

    Mrs. Bennett ...

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