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.