What we see here is quite clear: Diffuse peritonitis, subphrenic on the right fibrin and infected ascites.But what could be the cause?History: 2 weeks ago pain, GP, Voltaren, symptoms significantly better. Patient, 73 years old maintains his seriously ill wife and is unable to cope. Yesterday he came to the stationary interior department because of relapsing abdominal pain.Findings: Abdominal soft, hardly any muscular defense, diffuse pressure pain.Laboratory: Leuco 7.000, CRP normal. Potassium and calcium significantly decreased. Lipase normal, Quick 60%Yesterday: supposedly unaff. Sono. Today abdome sono: Massive free liquid subphrenic and in douglas. I immediately conducted a laparoscopy: The photo shows the findings.What do you think? a App. perforata b. Perfor. divertikulitis c. Perfor. duodenal ulcer d. Spontaneous bacterial peritonitisHelp: Laboratory and clinical findings are not compatible.
