What's the Diagnosis? By Dr. Karen O'Brien
A 66 yo M w/ history of prior duodenal perforation s/p numerous graham patch repairs and prior endovascular aortic repair presents to the ED w/ altered mental status and hypotension w/ a SBP in 60s. He is emergently intubated. RUSH exam is done and free fluid is noted in the abdomen. His post-intubation CXR is shown below. What's the diagnosis? (scroll down for answer)