Tuesday, March 31, 2015

PERTONITIS Investigations


INVESTIGATIONS

The  minimum  investigations required to  establish  an  accurate
diagnosis are:

*  Plain X-ray abdomen to detect

   -  Air under the diaphragm (perforation)
   -  Air fluid levels (intestinal obstruction)
   -  Gallbladder or urinary stones
   -  Evidence of fluid in peritoneal cavity

*  Blood examination

   -  Raised total leucocytes
   -  Raised ESR
   -  Electrolytes examination

*  Urine  examination for R.B.C. and pus cells in case  of  renal
   origin of pain

*  Peritoneal tap in doubtful cases.

3.4 NEW IMAGING

CT  Scanning and ultrasound scan provide information  on  changes
related to the diseased organ causing the acute abdomen  syndrome
and  also the changes related to peritonitis and the  sequlae  of
abdominal   abcess   and  its   location   (parateolic,   pelvic,
subdiaphragmatic). Fig. 21.4

Colour  Doppler ultrasonography can give accurate information  on
the  state  of  the  blood vessals  of  the  abdomen,  aneurysms,
thrombism arterio-venous fistulas can be detected.

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