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Gnawing abdominal pain that gradually intensifies, on and off vomiting, positive direct tenderness on all quadrant. Why ?

26 y.o. male was working when he experienced gnawing abdominal pain which gradually increased in intensity, sometimes being on and off associated with vomiting and fever. patient is non-diabetic and non-asthmatic. no food and drug allergies . BP = 120/80 HR = 95/min RR = 26/min Temp: = 37.9 deg celcius. Distended abdomen, positive direct tenderness on all quadrants, negative rebound, ill-defined masses on all quadrants. What are your impressions and why?
Asked On : Fri, 19 Oct 2012
Answers:  1 Views:  49
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Cardiologist 's  Response
It is rather unusual to have masses in all quadrants -
Tenderness in all quadrants? - this suggests generalised peritonitis. It will be difficult at this time to localise.
Perforated viscus is highly probable.
In certain countries, Familial Mediterranean Fever is a priority.
Whatever it may be, the approach should be immediate admission, repeated clinical assessment, blood tests, scans, second opinion. It sounds serious. It may need laparatomy at any time.
Don't delay / Take care
Good luck
Answered: Fri, 19 Oct 2012
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