Fever in Surgery — 43yo Man | General Surgery | SMLE Q#16860
SMLE Question #16860
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 43-year-old man has 18 hours of worsening generalized abdominal pain that began peri-umbilically and is now severe and diffuse, with fever, nausea, and bilious vomiting. He has not passed flatus or stool for 12 hours. He had an open appendectomy 15 years ago. He lies still and avoids movement. Exam shows marked abdominal distension with generalized tenderness, guarding, and rebound; bowel sounds are absent. Upright chest and abdominal radiographs show free intraperitoneal air under the diaphragm. What is the most appropriate next step in management?
Continue in practice mode
Sign in and start a focused practice session to view options, submit your answer, and read the full explanation.