A 51-year-old man with a past medical history of peptic ulcer disease currently being treated with triple therapy presents to the urgent care center complaining of acute abdominal pain which began suddenly less than 2 hours ago. The physical examination shows his abdomen to be mildly distended, diffusely tender to palpation, and positive for rebound tenderness. The remaining physical examination is unremarkable. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 106/64 mm Hg, heart rate 108/min, and respiratory rate 19/min. Which of the following diagnostic tests is most appropriate to order?
Correct answer: CT abdomen and pelvis
General Feedback
This patient is presenting with signs of peritonitis which, given his history of peptic ulcer disease (PUD), is concerning for ulcer perforation. A contrast-enhanced CT scan of the abdomen and pelvis will help to evaluate for pneumoperitoneum and/or free intraperitoneal fluid. Given his acute presentation, this is the most appropriate next step.
A 51-year-old man with a past medical history of peptic ulcer disease currently being treated with triple therapy presents to the urgent care center complaining of acute abdominal pain which began suddenly less than 2 hours ago. The physical examination shows his abdomen to be mildly distended, diffusely tender to palpation, and positive for rebound tenderness. The remaining physical examination is unremarkable. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 106/64 mm Hg, heart rate 108/min, and respiratory rate 19/min. Which of the following diagnostic tests is most appropriate to order?
Correct answer: CT abdomen and pelvis
General Feedback
This patient is presenting with signs of peritonitis which, given his history of peptic ulcer disease (PUD), is concerning for ulcer perforation. A contrast-enhanced CT scan of the abdomen and pelvis will help to evaluate for pneumoperitoneum and/or free intraperitoneal fluid. Given his acute presentation, this is the most appropriate next step.