23rd August 2023

A 45-year-old man presents to the emergency department with sudden onset of severe abdominal pain and distension

A 45-year-old man presents to the emergency department with sudden onset of severe abdominal pain and distension. He has a known history of cirrhosis due to chronic alcohol use. His observations reveal tachycardia and hypotension. On examination, his abdomen is distended, tense, and tender on palpation.

What is the most appropriate next step in management?