Acute abdomen: perforated ulcer: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Acute abdomen: perforated ulcer

Sample item

A patient has abrupt severe epigastric pain, a rigid board-like abdomen, and free air under the diaphragm on an erect chest radiograph. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Perforated peptic ulcer

Free intraperitoneal air with peritonitis strongly suggests perforation of a hollow viscus; a perforated peptic ulcer is a common cause. Resuscitation, antibiotics, surgical assessment, and source control are urgent.

Option by option

  • A. Perforated peptic ulcer (correct)

    Correct. The radiographic free air and peritonism fit a perforated gastroduodenal ulcer.

  • B. Renal colic

    Renal colic causes flank pain and hematuria without peritonitis.

  • C. Uncomplicated constipation

    Constipation does not cause a rigid abdomen with free subdiaphragmatic air.

  • D. Acute hepatitis

    Hepatitis causes jaundice and hepatocellular inflammation, not free intraperitoneal air.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Perforated peptic ulcer. Free intraperitoneal air with peritonitis strongly suggests perforation of a hollow viscus; a perforated peptic ulcer is a common cause.

Why is "Renal colic" not the answer?

Renal colic causes flank pain and hematuria without peritonitis.

Why is "Uncomplicated constipation" not the answer?

Constipation does not cause a rigid abdomen with free subdiaphragmatic air.

Why is "Acute hepatitis" not the answer?

Hepatitis causes jaundice and hepatocellular inflammation, not free intraperitoneal air.

What concept does this question test?

It tests Acute abdomen: perforated ulcer in General Surgery. Resuscitation, antibiotics, surgical assessment, and source control are urgent.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Acute abdomen: perforated ulcer?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.