A 57-year-old man has sudden severe generalized abdominal pain. He is rigid with rebound tenderness; upright chest radiograph shows free air under

Question

A 57-year-old man has sudden severe generalized abdominal pain. He is rigid with rebound tenderness; upright chest radiograph shows free air under the diaphragm. Which of the following is the most appropriate next step?

Accepted Answer

Begin resuscitation and broad-spectrum IV antibiotics, and obtain urgent surgical source control

Answer

Begin IV proton-pump inhibitor therapy and arrange endoscopy after stabilization

Answer

Observe with serial abdominal examinations after initial analgesia and fluids

Answer

Perform image-guided peritoneal drainage as definitive treatment before surgical review

Answer

Obtain contrast CT before giving antibiotics or contacting surgery

Perforated viscus — MCCQE Part 1 MCQ

A 57-year-old man has sudden severe generalized abdominal pain. He is rigid with rebound tenderness; upright chest radiograph shows free air under the diaphragm. Which of the following is the most appropriate next step?