How to check for gastric perforation? It turns out that you need to check these

Although gastric perforation is a common disease in daily life, few people know the answer to the question of how to check gastric perforation. In fact, there are four types of examinations for gastric perforation. Let us take a closer look at the four types of examinations that patients with gastric perforation should undergo to confirm the diagnosis!

examine

1. Perform exploratory abdominal puncture and examine the extracted fluid under a microscope. If white blood cells or pus balls are seen filling the entire field of view, it indicates inflammatory ascites, which is evidence for the diagnosis of peritonitis. The ammonia content can also be measured. If it exceeds 3μg/ml, it indicates gastrointestinal perforation.

2. X-ray examination, especially upright abdominal plain film, can usually reveal free gas under the diaphragm. The method of displaying pneumoperitoneum is generally through fluoroscopy and photographic examination. In particular, the display of a small amount of pneumoperitoneum is particularly important. If the condition permits, standing fluoroscopy and rotational observation can often show the presence of crescent-shaped free gas under the diaphragm, because gas always tends to float to the highest point of the abdominal cavity. After confirming the free gas under the diaphragm, photographs should be taken immediately for clinical reference.

3. Ultrasound and CT examinations can help confirm the diagnosis.

4. Laboratory examination: White blood cell count may be increased. In general, in cases of acute perforation, the white blood cell count is between 15,000 and 20,000/mm3, and the neutrophil count increases. The hemoglobin and red blood cell counts also increase due to different degrees of dehydration.

diagnosis

The diagnosis is not difficult to make based on clinical manifestations and related examinations. The traditional method for diagnosing gastrointestinal perforation is to take an abdominal X-ray to observe whether there is free gas under the diaphragm and abdominal wall, which is used as the main basis for diagnosis, but the accuracy is limited.

Identification

Pneumoperitoneum caused by gastrointestinal perforation needs to be differentiated from the normal anatomical variation of the interstitial colon. Rotation of body position under fluoroscopy can be used for identification.