23rd August 2023

A 25-year-old female presents to the emergency department with acute onset of severe generalised abdominal pain, nausea, and vomiting

A 25-year-old female presents to the emergency department with acute onset of severe generalised abdominal pain, nausea, and vomiting. She is tachycardic, hypotensive, and febrile. Abdominal examination reveals generalised tenderness and rigidity. Erect chest X-ray shows air under the diaphragm.

What is the most likely diagnosis?