Authors: Ivan Kisyov, Stephen E McCabe/ Editor: Steve Corry-Bass / Reviewer: Stephen E McCabe / Codes: GP1, GP9, SLO1, SuP7 / Published: 25/11/2022

A 24-year-old patient has presented with vomiting, abdominal pain, constipation and neck swelling.

He sustained multiple stab wounds to his chest and abdomen last month, requiring surgical repair. This was followed by an uneventful recovery.

Three days ago he started to develop abdominal pain. This has worsened and is now constant, suprapubic / Right Iliac Fossa, 8/10, sharp in nature and associated with vomiting.

Two days ago he started to notice some swelling in his neck which has gradually become more painful.

He last opened his bowels 2 days ago and passed flatus this morning.

He feels otherwise well and reports no symptoms on systems review.

He is currently taking co-codamol for his post operative pain.

His chest X-ray is shown.