Gastrointestinal perforation, also known as ruptured bowel, is a hole in the wall of part of the gastrointestinal tract. The gastrointestinal tract includes the esophagus, stomach, small intestine, and large intestine. Symptoms include severe abdominal pain and tenderness. When the hole is in the stomach or early part of the small intestine, the onset of pain is typically sudden while with a hole in the large intestine onset may be more gradual. The pain is usually constant in nature. Sepsis, with an increased heart rate, increased breathing rate, fever, and confusion may occur.The cause can include trauma such as from a knife wound, eating a sharp object, or a medical procedure such as colonoscopy, bowel obstruction such as from a volvulus, colon cancer, or diverticulitis, stomach ulcers, ischemic bowel, and a number of infections including C. difficile. A hole allows intestinal contents to enter the abdominal cavity. The entry of bacteria results in a condition known as peritonitis or in the formation of an abscess. A hole in the stomach can also lead to a chemical peritonitis due to gastric acid. A CT scan is typically the preferred method of diagnosis; however, free air from a perforation can often be seen on plain X-ray.Perforation anywhere along the gastrointestinal tract typically requires emergency surgery in the form of an exploratory laparotomy. This is usually carried out along with intravenous fluids and antibiotics. A number of different antibiotics may be used such as piperacillin/tazobactam or the combination of ciprofloxacin and metronidazole.
Most commonly, electric injuries primarily damage the outer limbs, but more critical portions of the body may be affected as well causing severe complications.As the body comes into contact with an electrical source, it becomes part of the electrical circuit. As such, the current has a point of entry and an exit at two different points on the body. The point of entry tends to be depressed and leathery whereas the exit wound is typically more extensive and explosive. It is hard to accurately diagnose an electrical burn because only the entry and exit wounds are visible and the internal damage is not. Prevention
Basic electrical safety
The following are some examples of unsafe practices which could lead to electric injury (this list is not exhaustive. ):
Using electrical appliances while wet (showering, bathing, etc.) as plumbing is often connected to electrical ground, and wet skin loses much of its resistance. Exception for newer quality appliances intended for the bathroom when not simultaneously showering, bathing, being in a path of water going to plumbing, or touching bare concrete or sheet metal. Standing on a dry carpet or rug is ideal. All power mains outlets should have a wall cover to avoid accidentally touching the electrified sides between the wall and outlet. This is especially important for children, as their small fingers can easily reach into this gap along the sides. Using AC electrical appliances around bathtubs, swimming pools, hot tubs, etc. with the risk that the appliance may fall into the water and cause electrocution.