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MediumEmergency MedicinePerforated Peptic Ulcerukmlamrcp part 1mrcem sbapane

A 50-year-old man with a history of peptic ulcer disease presents with sudden onset severe epigastric pain, described as 'like being stabbed'. On examination, he is lying still, pale, and sweaty. His abdomen is rigid ('board-like') with generalised tenderness and guarding. Bowel sounds are absent. What is the most likely diagnosis?

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