Where There Is No Doctor 2011 93
MEDICINE FOR A WOUND THAT GOES INTO THE GUT
(Also for appendicitis or peritonitis)
Until you can get medical help, do the following:
Inject ampicillin (p. 352), 1 g. (four 250 mg. ampules) every 6 hours. Also give
metronidazole (p. 369), 1 g. every 12 hours.
If possible also give ciprofloxacin (p. 356), 500 mg. every 12 hours.
If there is no ampicillin:
Inject penicillin (crystalline, if possible, p. 352), 5 million Units immediately;
after that, 1 million units every 4 hours. Also give metronidazole and if
possible, ciprofloxacin.
OR inject ceftriaxone, 1 g. every 24 hours. Also give metronidazole
and ciprofloxacin.
If you do not have these antibiotics in injectable form, give ampicillin or penicillin
by mouth, together with metronidazole and ciprofloxacin and very little water.
EMERGENCY PROBLEMS OF THE GUT (ACUTE ABDOMEN)
Acute abdomen is a name given to a number of sudden, severe conditions of
the gut for which prompt surgery is often needed to prevent death. Appendicitis,
peritonitis, and gut obstruction are examples (see following pages). In women, pelvic
inflammatory disease (often with vaginal discharge, see p. 243), or an out of place
pregnancy (in the tubes) can also cause an acute abdomen. The exact cause of acute
abdomen may be uncertain until a surgeon cuts open the belly and looks inside.
If a person has continuous severe gut pain with vomiting,
but does not have diarrhea, suspect an acute abdomen.
ACUTE ABDOMEN:
Take to a hospital—
surgery may be needed
• continuous severe pain that keeps
getting worse
• constipation and vomiting
• belly swollen, hard, person protects it
• severely ill
LESS SERIOUS ILLNESS:
Probably can be treated
in the home or health center
• pain that comes and goes (cramps)
• moderate or severe diarrhea
• sometimes signs of an infection,
perhaps a cold or sore throat
• he has had pains like this before
• only moderately ill
If a person shows signs of acute abdomen,
get him to a hospital as fast as you can.