Clinical Practice and Cases in Emergency Medicine

Introduction: Acute abdomen is a common emergency presentation, and gastrointestinal perforation can be rapidly fatal if not promptly identified. Point-of-care ultrasound (POCUS) offers a rapid bedside alternative when advanced imaging is delayed or unavailable. 

Case Report: We report a 40-year-old man presenting in cardiac arrest, resuscitated after ten minutes, with subsequent findings of abdominal distension and prior epigastric pain. Point-of-care ultrasound demonstrated classic signs of pneumoperitoneum, and intestinal perforation was confirmed by the drainage of feculent fluid. Despite intervention, the patient expired. 

Conclusion: This case underscores the value of POCUS in diagnosing perforation in unstable patients, guiding emergent decisions when transfer or definitive imaging is not feasible.