Medical History A 34-year-old otherwise healthy male patient presents to the emergency department with sudden onset of severe abdominal pain in the periumbilical region, associated with rectal pain and bleeding. He denies constitutional symptoms or anorectal trauma. In the initial evaluation, the patient undergoes a chest radiography. Anteroposterior (AP) chest radiograph. Question:Based on the clinical history and imaging study, we can assume that: Tympanism in the right upper quadrant is not expected during percussion of this patient's abdomen Chest radiography is useless for detecting mild pneumoperitoneum. Intraperitoneal perforation of the rectum caused by insertion of a foreign body is the most likely diagnosis. The patient might be diagnosed with Chilaiditi's Syndrome Time is Up! Time's up
