Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of prolonged high-grade fever, malaise, and abdominal pain, now exhibiting signs of acute abdomen. Recent progression to sudden, severe, generalized abdominal pain, guarding, and rebound tenderness suggests intestinal perforation. History of recent travel to endemic areas, consumption of contaminated food/water, and prior symptoms of constipation or "pea-soup" diarrhea noted.
Clinical Examination Findings
Patient appears toxic, febrile (T: [Temp]), and tachycardic. Abdominal examination reveals board-like rigidity, absent bowel sounds, and diffuse tenderness consistent with peritonitis. Rectal examination may show occult blood. Signs of shock (hypotension, cool extremities) should be assessed. Hepatosplenomegaly may be present.
Treatment Protocol
Immediate surgical consultation for exploratory laparotomy and repair of perforation. Initiate aggressive intravenous fluid resuscitation and broad-spectrum parenteral antibiotics (e.g., Ceftriaxone or Ciprofloxacin). Maintain NPO status, nasogastric decompression, and monitor electrolytes and acid-base balance. Analgesia and hemodynamic monitoring in ICU setting.