A 53-year-old male presents to the emergency department with sudden onset severe abdominal pain and distension. His abdomen is rigid on examination and he reports a history of peptic ulcer disease. Which diagnostic approach is most appropriate to confirm the suspected diagnosis of bowel perforation?
An upright chest X-ray is most appropriate for confirming suspected bowel perforation as it can effectively show free air under the diaphragm, which indicates perforation. Abdominal ultrasound, while useful for assessing other abdominal conditions, might not reliably detect free air. CT scan, although accurate, is not the initial diagnostic tool typically used in an acute emergency setting before X-ray due to its less availability and longer setup time. MRI is not indicated in acute settings due to the time it takes and is generally not used for gastrointestinal emergencies such as bowel perforation.
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BCEN CEN
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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