Imaging Case of the Week 9

It is 2 am again and you are about to see your next patient, a little old lady with abdominal pain and tachycardia.

You want to take a detailed and thorough history from her in regards to her abdominal pain but she couldn’t care less. She is conscious but prefers to keep her eyes shut and is wincing. You initially think that she is a ‘poor historian’ but finally figure out 10 minutes later that she is in a lot of pain. You manage to give her IV opioids and then examine her tummy. You plan to request an erect chest and abdominal x-ray as your 1st investigation. Her erect chest x-ray is here. On re-examination, she is getting more sick. What would you do next?

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