Dr. Narendra Kumar (Internal Medicine) needs a second opinion on this medical case.
*Chief Complaint* A 76 y/o male is presented with abdominal pain with nausea and vomiting. *History* 6 days prior he had surgery for right femur fracture with proximal intramedullary nail. He has h/o surgery for appendectomy. *Vitals* *Blood pressure-125/75 mmhg, HR- 109 beats/min, Respiratory rate-19 bpm, Temp-99.3 degree F. *Examination* Abdominal distension on rt side. Other examination is unremarkable. *Investigations* Hb- 12.1 g/dL, WBC-13.05 × 109/l, C-reactive protein 18 mg/dL. CT- thickeness of small bowel with free air noted on rt side + perforation of jejunum. *Treatment* Please give your advice.
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