Gastrointestinal perforation is a common abdominal emergency having a high morbidity and Mortality. Time to definitive surgical management depends on the speed with which an emergency Physician establishes this diagnosis in a patient presenting pain abdomen to ER (Emergency Room).
Traditionally, the diagnosis of intestinal perforation is dependent on classical x-ray picture of free gas under diaphragm, the absence of which practically tends to push the diagnosis down the list of differentials.
We present here a case of an acute abdomen where x-ray erect chest and abdomen were normal and a timely POCUS (Point-of-care Ultra Sound) done by emergency physician revealed features of intestinal perforation which fast-tracked the process of confirming the diagnosis and early operative intervention.
Rakesh Attaluri