A 48-year-old woman presented to the emergency department due to a fever of two days duration. The patient has fatigue, nausea, vomiting, and severe epigastric abdominal pain. She has had epigastric abdominal pain for the last 2 months. The patient has a previous medical history of chronic hypertension. On examination, the abdomen has generalized tenderness, rebound tenderness is positive. An upright chest x-ray is shown below. Which of the following is the cause of the patient's presentation?

Question

Quizplus · Accepted Answer

Eductional Objective: Pneumoperitoneum is most commonly caused by a perforated duodenal ulcer. It causes peritonitis, the patient presents with generalized abdominal tenderness, rebound tenderness, and rigidity.

A 48-Year-Old Woman Presented to the Emergency Department Due to a Fever