A 40 years old male was brought to the emergency with severe abdominal pain. On examination, pulse rate was 112/minute and systolic BP was 80 mm Hg. Chest X-ray is given below. What is the most appropriate management?: (A) Exploratory laparotomy, (B) Intercostal tube drainage, (C) Saline wash of stomach, (D) IV antibiotics
Answer is A. X-ray - Gas under right dome of diaphragm - secondary bacterial peritonitis Secondary bacterial peritonitis (SBP) Due to perforation Spillage of intestinal contents Polymicrobial E. coli + Bacteroides Mx: Exploratory laparotomy. + Drain