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What is A 40 years old male was brought emergency with severe abdominal pain. On examination, pulse rate was 112/minute and systolic BP was 80 mmHg. Chest x-ray is given below. What is the most appropriate management? and explain in detail?
From the given hx.: Pulse rate - 112 / min - Tachycardia - Indicates that patient is in Shock SBP - 80 mmHg - Low Bp X-ray shows: - Free gas under the right dome of diaphragm - Pneumoperitoneum - Due to perforation peritonitis which may be due to GI perforation such as perforated gastric ulcer, appendix or diveiculum Investigation: 1st investigation: X-ray Best IOC: Spiral CT T/t of choice: exploratory laparotomy