Diagnosis and management of gastrointestinal perforations in XXXX with particular reference to perforations of the duodenum.

@entity1 @entity6017 @entity39 @entity1333 @entity344 @entity204
Four @entity1 with @entity6017 were recently seen with gastrointestinal perforations. The sites of perforation in the four cases were: (1) the duodenum, esophagus, and colon; (2) the duodenum; (3) the distal stomach; and (4) the traverse colon. The gastric and transverse colon perforations were intraperitoneal and easily diagnosed. The gastric perforation was treated successfully by partial gastrectomy. The @entity1 with the colon perforation underwent exteriorization; @entity204 occurred from cerebral complications possibly related to @entity1333 . Both duodenal perforations were posterior in the distal descending portion. Enzymatic dissection into the right lower quadrant produced confusing clinical and radiographic signs and @entity39 . Successful treatment was obtained by partial gastrectomy, sump drainage of the perforation, and parenteral nutrition. @entity344 is a well-recognized complication of @entity1333 in @entity6017 . In particular, perforations of the distal duodenum, as reported by others, are associated with delay in diagnosis and high mortality.
