This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: GIT, Subject name: Surgery
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? 
Select and explain. 
A. Exploratory laparotomy, B. Intercostal tube drainage, C. Saline wash of stomach, D. IV antibiotics
A: Exploratory laparotomy
Answer: A: Exploratory laparotomy 
Explanation: 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