A 56-year-old man, with a known history of peptic ulcer disease, complained of sudden onset of severe epigastric pain for one day. General examination revealed that the patient was afebrile but in severe pain. Abdominal examination showed generalized tenderness and guarding of the abdomen with ‘board like’ rigidity.
Laboratory investigations were essentially normal. An erect chest x-ray (CXR) (left image) and a supine abdominal x-ray (AXR) (right image) were performed.
What abnormality can you see and what is the diagnosis ?
