Critical Cases - Spontaneous Bacterial Peritonitis!

A 58 year old man with a history of stage IV pancreatic adenocarcinoma, currently on chemotherapy, presents with chief complaint of RLQ abdominal pain. He appears in severe pain as you enter the room and his abdomen appears disteneded and stretched tight. Small bowel obstruction? you think as you approach the bedside. Not so fast!

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Sharp Foreign Body Ingestion

Consider a case: a 38 year-old male presents to the ED after intentional ingesion of multiple objects, which include razor blades, a fork and other sharp objects. Vital signs are stable, he has no abdominal tenderness, and an x-ray reveals several foreign bodies in the stomach that appear consistent with sharp objects, with no free air under the diaphragm.  How do you approach this scenario and other similar cases?

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