Failure to Diagnose & Delay in Treatment of Acute Abdomen Due to Perforated Bowel (Gastrointestinal Perforation, GP)

Evaluate breaches in the standard of care to determine if there was a Failure to Diagnose & Delay in Treatment of Acute Abdomen Due to Perforated Bowel (Gastrointestinal Perforation, GP)

Answer the following questions to find out if the standard of care was followed for your case.

  • With which of the following symptoms did the patient present? (Choose all that apply)
    Nausea
    Vomiting
    High fever
    Absent bowel sounds
    Abdominal pain
    None elicited
    Answer unknown
    Why is this important?
    Gastrointestinal perforation is a hole that develops through the entire wall of the stomach, small intestine, large bowel, or gallbladder. This condition is a medical emergency.
    (2008) 65 ESEUJR 1 125-132

  • Was a detailed medical history regarding the following obtained? (Choose all that apply) Why is this important?
    Answer this question
    A complete medical history and carefully focused physical examination serve as the core of the diagnostic process. The information obtained guides the further direction of the patient's evaluation and enables the clinician to make the most judicious use of additional tests. It helps determine the value of incongruent and conflicting results that can emerge during the diagnostic process, and it can obviate the need for tests that are costly or expose the patient to discomfort or risk. The deep understanding of the patient that can be obtained only through the immediacy of the history and physical examination also plays a pivotal role in treatment decisions that must be addressed at various points throughout the patient's lifetime.
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  • Were the patients vital signs assessed? Why is this important?
    Answer this question
    Vital signs must be assessed for fever, tachycardia and blood pressure as they are indicators of underlying cause.
    (2008) 92 EMEDCN 3 599-625

  • Was a thorough physical examination performed? Why is this important?
    Answer this question
    The physical exam is vital to secure the diagnosis and to detect co-existent diseases that may affect treatment options or may require specific preoperative interventions.
    (2008) 92 EMEDCN 3 599-625

  • Which of the following diagnostic laboratory studies were performed? (Choose all that apply) Why is this important?
    Answer this question
    Formal diagnosis is made through laboratory tests. Supplemental laboratory studies are selectively ordered.
    (2008) 92 EMEDCN 3 599-625

  • Which of the following diagnostic imaging studies were performed? (Choose all that apply) Why is this important?
    Answer this question
    Radiographic evaluation of the acute abdomen traditionally begins with a three view abdomen series consisting of an upright chest radiograph and an upright and supine abdominal radiograph.
    (2008) 92 EMEDCN 3 599-625

  • Was the patient referred to a surgical gastroenterologist? Why is this important?
    Answer this question
    Once priorities and goals have been agreed on, referral to the appropriate professionals must be made in a timely manner. To deliver care requires a coordinated approach that allows sharing of skills and expertise. The skills of members from all professional disciplines must be utilized to enable all patients to achieve their maximum potential.
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  • Which of the following treatment options were initiated? (Choose all that apply) Why is this important?
    Answer this question
    The most important therapy for gastrointestinal perforation is source control. Traditionally, source control is achieved through surgery.
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  • Were follow-up evaluations advised? Why is this important?
    Answer this question
    Routine follow-up evaluations are necessary to offset any complications that may arise.
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