Signs

• patient lies quietly (pain aggravated by movement and coughing)

• pale, sweating or ashen at first

• board-like rigidity

• maximum signs at point of perforation

• no abdominal distension

• contraction of abdomen (forms a 'shelf over lower chest)

• bowel sounds reduced (silent abdomen)

• shifting dullness may be present

• pulse, temperature and BP usually normal at first

• tachycardia (later) and shock later (3-4 hours)

• breathing is shallow and inhibited by pain

PR: pelvic tenderness

X-ray: Chest X-ray may show free air under diaphragm (in 75%)—need to sit upright for prior 15 minutes.

Limited Gastografin meal can confirm diagnosis.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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