Author: Metin Yadigaroğlu
Date: 29 October 2019

83 years old, female patient came to ED with abdominal pain, nausea, vomiting and fever. The patient was diagnosed with alzheimer’s disease previously and was bedridden. She was complaining about constipation for a week and patient’s relatives were discharging their patient’s stool with either enema or manually.

Patient’s vital signs were within normal limits except mild fever (37.8 °C). In her physical examination there was sensitivity and rebound tenderness in her whole abdomen. She was diagnosed as acute abdomen and her bedside ultrasound revealed that there were many air artefacts around liver and gallbladder cannot be visualized because patient had an cholecysctectomy before. There was increase in her infective parameters in her laboratory tests. CT scan was performed and patient was diagnosed with perforation and went to the operation.

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Authors: Mehmet Ali Aslaner, Asst. Prof. · 24 January 2018