A 55 year old man was admitted in medicine ward from emergency department due to breathlesness. On clinical examination, his abdomen was found rigid, tense and tender with sluggish IPS. Straight xray abdomen was done and found to have gas under diaphragm. The person was smoker and he was having chronic epigastric pain. Authors: Dr. Kaushik Mondal, MBBS, MD (Calcutta National Medical College and Jhargram Superspaciality Hospital), Dattatreya Mukherjee, MBBS ( Jinan University, P.R China)
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