70-year-old male admitted with multi-organ failure and intra-abdominal sepsis secondary to perforated duodenum post lap cholecystectomy. Candidates were directed to assess the patient with a view to determining the current problems and making a management plan for the next 24-48 hr. Discussion points included intra-abdominal sepsis, antibiotic choice, use of vasopressors, anticoagulation for CRRT, nutrition plan and CXR and ABG