HY USMLE Q #790 – Gastro

A 49-year-old man is brought to emergency by his wife 30 minutes following abrupt-onset abdominal pain where he feels like he was “kicked in the abdomen.” He has a history of abdominal pain after meals for which he takes over-the-counter antacids. Vitals are: temperature 100F, HR 90, RR 16, BP 150/95. An x-ray of the chest is shown. Which of the following is the most likely diagnosis?

  Duodenal hematoma
  Hemothorax
 Perforated viscus
  Pneumobilia
  Pneumothorax

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