A 30 years old male patient presented with abdominal pain, fever, nausea, vomiting and respiratory distress. His BP was found to be 80/40 mm Hg and pulse rate of 115/min. The following chest X-ray was recorded in ER. What is the immediate management?
A. IV fluids and antibiotics followed by laparotomy
B. Immediate laparotomy
C. Intravenous fluids
D. Intravenous potassium
Ans: A. IV fluids and antibiotics followed by laparotomy
(Ref: Sabiston 20Ie p1079, 19Ie p1100-1102; Bailey 27/e p1051¬1052, 26/e p971-974)
- Chest X-ray is showing air under the right dome of diaphragm, which is seen in perforation peritonitis.
- In cases of perforation peritonitis, laparotomy is the treatment of choice alter fluid resuscitation of the patient and IV antibiotics.