BCEN CEN Practice Question

Sudden, severe abdominal pain with involuntary guarding and a board-like abdomen indicates diffuse peritonitis, most commonly from a perforated viscus. This condition carries high morbidity and mortality and typically requires operative source control. Management in the emergency department should begin with resuscitation (airway, IV access, crystalloid fluids), prompt broad-spectrum antibiotics, analgesia, and an emergent surgical consultation. Definitive treatment cannot occur without surgical evaluation, and imaging studies-while helpful-should not delay surgical involvement. Analgesia alone does not address the life-threatening pathology, imaging may postpone operative management, and antibiotics by themselves will not repair the perforation. Therefore, obtaining immediate surgical consultation is the best next step.