1. Intestinal Perforation
Scenario 4.2
Intestinal Perforation

2. Chest X-ray

3. Abdominal X-ray

4. FAST

5. Abdominal CT Slice

6. CT Abdomen Radiology Read
STUDY: Abdomen/Pelvis CT
FINDINGS:
CT obtained with oral contrast. Shows free air throughout the abdomen. No other obvious abnormalities.
IMPRESSION:
Peritoneal free air – suspected intestinal perforation.

7. CBC WBC 19.6 10 000-30 000/mm3 HGB 13.2 11-15 g/dL HCT 44 40-50% PLT
176
/mm3

8. BMP Glucose 115 65-100 mg/dL BUN 16 5-20 mg/dL Sodium 137
meq/L
Potassium
3.8
meq/L
Chloride 99
meq/L
CO2 33
22-32 meq/L
Creatinine
0.9
mg/dL

9. Hepatic Function Panel
AST 17
19-48 U/L
ALT 32
17-60 U/L
Alk. phos. 53
U/L
T. Bili
1.0
mg/dL
Albumin
3.8
g/dL
GGT 45
12-58 U/L

10. Lactate
Lactate
3.4
mmol/L

11. Lipase
Lipase 25
21-53 U/L

12. Urine Pregnancy Test
Negative

13. Urine microscopy Urine RBC None seen NS/HPF Urine WBC Urine epithelial
cells
Urine bacteria
/HPF
Urine casts
NS/LPF

14. Urinalysis Clarity clear Color yellow Glucose negative negative mg/dL
Bilirubin
Ketones
Sp. grav.
1.020
Blood pH
5.0
Protein
Urobilinogen
0.1
0.2 EU/dl
Nitrites
Leukocytes
Urinanalysis