Question 162 · LEK · Gastrointestinal perforation
A 45-year-old patient, a smoker abusing alcohol, has been admitted to the ED with severe abdominal pain. On admission the patient presents pale, wet skin, and complains of unbearable abdominal pain that intensifies while he moves. On examination the abdominal guarding and absent bowel sounds are noted. The patient reports that the pain started acutely in the epigastric region and then extended to the whole abdomen. Which of the following examinations should be performed in the first place?
- A. abdominal ultrasound imaging.
- B. chest X-ray and a plain frontal radiograph of the abdomen in erect posture.
- C. abdominal CT.
- D. gastroscopy.
- E. none of the above.
Hint
Sudden epigastric pain spreading to a board-like abdomen in a smoker who drinks suggests perforation; which quick test shows free gas?
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