If ulcer is blast the person can live or die how to identify the ulcer. Operation is done immediately or we can wait to do operations ct scan is necessary to do for that patient blood pressure should be normal or not for scanning. Please advise

Dr. Shriniwas DeshpandeGeneral Surgeon24yrs exp

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Perforated ulcer is a Surgical Emergency. It can be diagnosed by an upright X-ray of the abdomen in which both domes of diaphragms are well seen. If the free air is obviously seen under the right dome of diaphragm, it is a classical diagnosis of the perforated viscus. Patient is rapidly resuscitated for his hemp dynamic imbalance and should be taken for the Emergency surgery, as early as possible. The surgery done in such cases is to open the abdomen, find out the perforated viscus, repair the perforation, clean the contaminated peritoneal cavity with liberal amount of lukewarm sterile normal saline, Drains are kept and abdomen is closed. In case if the plain X ray is not able to show the findings, then the CT abdomen helps in diagnosing the free air in the peritoneal cavity. It is suggested that the patient cannot moved to CT department in the unstable condition. I hope you are better informed now.  

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