investigations
Last reviewed 03/2023
The three principle conditions in the differential diagnosis of a suspected perforated peptic ulcer are acute pancreatitis, acute cholecystitis, and another perforated viscus e.g. colon diverticula. Investigations are directed at discriminating these conditions and preparing patient for possible surgery.
- blood tests - FBC, U+Es, LFTs, amylase, group and save
- erect CXR - may show gas under the diaphragm - and plain abdominal film
- ECG
- gastroscopy is contraindicated: this is because the stomach is inflated during this procedure, and air and gastric contents would be propelled into the peritoneal cavity.