A young female with Perforated Viscus

A female aged 40 years Chief Complaints Pain Abdomen (Acute onset) Non passage of Flatus n Faeces High grade Fever (x 2 days) Physical Examination Distended and Tender Abdomen Absent bowel sounds Investigations CECT W/A

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This case is likely a c/o perforation as suspicious gas 8s seen in suprahepatic space with absence of flatus and faeces Intestinal sound is not heard so it is in ileus D/d 1 perforation of appendix 2 intestinal obstruction

Intestinal obstruction. Perforation of intestine. Acute peritonitis with paralytic illeus. Urgent laprotomy if pt is haemodynamically stable.

Intestinal obstruction Megacolon Chances of perforation Standing xray ap