A patient with a known history of PUD presents with acute abdominal pain. The kidney, ureter and bladder x-ray reveals free air under the diaphragm. What is the next best step in management?
A. Barium swallow
B. Outpatient management with proton pump inhibitor
C. Outpatient management with H2 blockade
D. Emergency surgery
E. Admission with serial abdominal exams
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