Complications of a gastroduodenal perforation (palliated) in the setting of multiple medical comorbidities
AI-generated summary
William Anthony Daniel, a 72-year-old SDA resident with intellectual impairment and multiple comorbidities, presented to Box Hill Hospital on 7 November 2024 with postural hypotension, nausea, vomiting and abdominal pain. CT imaging revealed a gastroduodenal perforation with free fluid and pneumoperitoneum. After discussion with family, a palliative approach was chosen rather than diagnostic laparoscopy or surgery, as these were deemed unlikely to improve quality of life. William was managed with intravenous antibiotics, fluids and analgesia. He deteriorated rapidly overnight with increased respiratory rate and severe pain, transitioned to end-of-life care, and died the following morning. The coroner accepted that this was a natural death from complications of gastroduodenal perforation in the setting of multiple medical comorbidities, with no inquest held.
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Specialties
general surgeryemergency medicinepalliative careintensive care
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