81 year-old female with a history of gastric cancer, supposedly in remission for 5 years, loses consciousness 2 months ago, which she immediately recovered but was left with paraplegia, began with recurrent ascites and progressive difficulty in eating food, oncology requested a jejunostomy that is performed without novelty, after 2 days it begins with bilious type vomiting, an rx review of the jejunostomy is performed finding it in its place, the next day it returns to the emergency with abdominal pain and shortness of breath and hypotensive, a tac o sheds more than thickening of the stomach wall. What do you suggest to do? ? What do you think is happening?
Abdominal pain and destination with hypotension suggest peritonitis .
I would think of tow possible causes in this patient … either dislodged jejeunostomy tube .
Or stomach cancer perforation …
Need Ct abdomen to confirm.