What is included in monitoring of patients with intestinal perforation who did not undergo surgery?

Updated: Jul 24, 2020
  • Author: Samy A Azer, MD, PhD, MPH; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

For patients treated with a nonsurgical approach, follow-up care consists of the following:

  • If the pain and fever settle within a few days, the patient can go home with a barium enema and sigmoidoscopy to be performed on an outpatient basis a few weeks later
  • Routinely perform colonoscopy if any doubt about the possibility of malignancy exists after barium enema examination
  • If the patient continues to be pyrexial and the pain does not settle or the lower abdominal mass is enlarged, ultrasonography and a water-soluble contrast enema may be necessary
  • If abscess is visible on ultrasound examination, it may be drained under ultrasonographic guidance
  • If the infection process fails to settle despite adequate conservative treatment, operation is indicated (primary resection, irrigation, and primary anastomosis)

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