d_raza1
Forum Senior
Topics: 32
Posts: 92
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In clinical exam. I saw a patient who presented with typical signs and symptoms of peritonitis. Past history was + for melena and indigestion, so the diagnosis was perforated peptic ulcer. Xray was given to me which showed gas under the right dome of diaphragm. then I was asked the D/D. What can be a D/D of such typical case of peritonitis (except perpaps we can say typhoid perforation, but in that case H/O fever shoudl be +) so what is answer of D/D?
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| FH
Forum Senior
Topics: 10
Posts: 136
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How about ca stomach??
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| Budlight
Forum Senior
Topics: 9
Posts: 92
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Indigestion ?
hard to tell, but i would still look for perforated peptic ulcer. if not found i would look for chronic pancreatitis, and if there is weight loss, i would definitely look for Upper GI cancer (long h/o pud regurge etc,) and finally i would also rule out any alcohol/liver pathology causing variceal bleed and perforation (boerhaave syndrome)
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